A New Way to Eat

I dedicate this book to my mother Hilla who I never knew and to her parents who became mother and father to me

“ There is one thing stronger than all the armies of the world And that is An idea that has come ” Victor Hugo Ask : “From whence, hath the idea come……”

Contents Foreword Preface Introduction 1. i. ii. iii. iv.

Think About Your Weight, Think About Your Diet Being Aware of Your Weight Analysing the Traditional Indian Diet The Traditional High Carbohydrate Diet and Its Effects The Ideal Diet

v. Vitamins, Minerals. Antioxidants 2. General Information Liquids; coffee versus tea; water; tomato juice; coconut water; milk; soft drinks; cane sugar; sugar substitutes; honey; vegetables; fruits; nuts; alcohol; salt; oil; cholesterol; coconut; calcium; sunlight; earth; exercise; breathing and yoga; mudra pranayama; acupressure; posture; bathing; hair care; teeth; nostrils; sleep; sex.

3. Composition of the Diet Carbohydrate; protein; oil; vegetables; curd; paneer; soya bean; pulses; sprouted pulses; oats; shellfish, chicken and egg; liquids; pickles and chutneys; snacks;high carbohydrate foods 4. The Complete Health Plan 5. Planning Your Own Diet; 6. Good Food, Bad Food; Eating Out and Junk Foods; Food Labels; Weddings and functions; When you are ill; Myths 7. Syndromes Related to Obesity Insulin resistance; hypothyroidism; polycystic ovarian disease; adult onset diabetes mellitus; Cushing’s syndrome; obesity related metabolic disturbances; trying to lose weight the second time; stress-related obesity 8. Adult Onset Diabetes

9. Monitoring Your Weight Loss/ Maintaining Your New Weight 10. Glossary 11 .Appendix 1 Food Values 12. Appendix 11 Medical References 13. Doctor’s Comments 14. Patient’s Comments 15. Reader Comment

Tables and Figures Tables 1.1 Morbidity Associated with Obesity 1.2 Height and Weight Charts (i) Children (ii) Women (iii) Men 1.3 Vitamins, Minerals and Antioxidants 2.1 Percentage of Fatty Acids Present on Various Oils 5.1 Food Values of Recommended Portions 5.2a Lunch or Dinner 5.2b Only Dinner 5.3a Karthika 5.3b Anupama 5.3c Vishal 5.3d Shyamala 5.3e Selvi 9.1 Protein Intake Chart A: Ten-day Weights and Measures Chart B: A Record of Food Eaten

Figures 1.1 Body-Mass Index for Obesity Abbreviations AHA

American Heart Association

BMI

Body Mass Index

CAD

Coronary Artery Disease

CHD

Coronary Heart Disease

DGLV

Dark green leafy vegetables

EFA

Essential fatty acids

GLA

Gamma linolenic acid

HDL

High density lipoprotein

IHD

Ischaemic Heart Disease

LDL

Low density lipoprotein

MUFA Monounsaturated fatty acids PUFA

Polyunsaturated fatty acids

SAFA

Saturated fatty acids

dsp

dessert spoon

g

gram/s

ltr

litre

min

minute/s

pkt

packet

tbsp

tablespoon

tsp

teaspoon

FOREWORD It gives me great pleasure to write this foreword for Dr Tusna Park’s book. I have been following Dr. Park’s work closely for several years.

She has adopted many novel principles in the dietary treatment of obesity. This book is very well written and gives a lot of new ideas which should certainly be tested by carrying out controlled, randomized clinical trials e.g. the efficiency of the soya bean and the use of a carbohydrate restricted diet. Traditionally the south Indian diet being a ‘ high carbohydrate diet ’ for years we have been advocating continuation of the same principles using a calorie restricted high carbohydrate diet.

Dr Tusna Park has now brought in the concept of using a ‘ carbohydrate restricted diet ’. From a physiological point of view, there are certain advantages using a low carbohydrate diet such as weight reduction and reduction of serum triglycerides. There is also emerging evidence that excess carbohydrate gets deposited as fat and from this point of view Dr Park’s ideas certainly merit further studies.

The book itself is very clearly written with direct take home messages .

Even though I may not agree with all the views expressed from the point of view in the treatment of diabetes, with regard to the treatment of obesity, I have no doubt at all, that the use of the principles outlined by Dr Tusna Park would be very effective in achieving significant weight reduction. Reduction of weight incidentally would have tremendous benefit as far as prevention of diabetes, correction of hyperlipidemia (serum cholesterol and triglyceride levels), controlling hypertension (high blood pressure) and prevention of coronary artery disease.

I congratulate Dr Tusna Park on her pioneering work and wish her and the book all success.

PROF .V. Mohan, M.D., M.N.A.M.S., Ph.D., D.Sc., Diabetologist and Managing Director M. V. Diabetes Specialities Center (P) Ltd 6 B, (Old No. 35) Conran Smith Road Gopalapuram, Chennai 600 086, INDIA

PREFACE

Our eating habits have worsened during the last fifty years, with the urban population being able to spend more on unhealthy foods like snacks, traditional sweets, bakery products and fast foods ( which are prepared from refined flour, saturated fats and hydrogenated oils ), ready made fried savories, sugary fruit syrups, packaged fruit juices, aerated and energy drinks. In addition, we have become more mentally active at the expense of physical activity, but continue to regularly eat the same quantity and quality of traditional foods that our grandparents ate in an age when they worked harder and were more physically active.

From birth to death the emphasis is on food. Infants are force fed to 'grow healthier'; children to 'think clearer'; expectant mothers are urged to eat even if they do not feel like eating, so that the baby will 'develop better'; daughters in law are encouraged to eat so that perhaps they can 'work harder' and young people are compelled to eat out of respect for elders. Every celebration, festival and religious event is centered around food which has as its base cereals, pulses and sugar.

Our main dish at every meal consists of either rice or wheat along with pulses and we consume sugar that is present in biscuits, soft drinks, milk drinks, ice creams, sweets and cakes. How many of us know that rice contains 78% carbohydrate and wheat contains 72% carbohydrate?

Honey contains 79% carbohydrate. We measure out honey carefully in teaspoons, while continuing to measure rice and wheat in cups! Sugar contains 99% carbohydrate, jaggery 95% and all the pulses except the soya bean contain about 60% carbohydrate. After digestion all carbohydrate is absorbed into the blood as glucose. This glucose cannot

be utilized by 60% of the urban population. Simply put, when blood glucose levels cross normal levels, the hormone insulin clears the excess glucose from the blood and converts it into fat, or, in those prone to Diabetes it manifests as high blood glucose. Unfortunately, high levels of insulin also increase triglycerides and LDL (bad) cholesterol and decrease HDL (good) cholesterol levels in the blood, thus predisposing us to heart disease.

According to a Nutrition Foundation of India (NFI) study, a third of the Indian urban middle class men and half of the middle class women are obese1. According to a WHO study, by 2010, India

had 50 million

Diabetic patients, making it the Diabetic capital of the world. Urban Indians are living dangerously in this age of Information and Technology. They sit for long hours, drink plenty of soft drinks and other junk foods made from maida, white rice, saturated and hydrogenated fats and are under enormous stress. We are experiencing today the ill effects of our unscientific eating in the form of obesity, adult onset diabetes mellitus, and coronary artery disease, which are becoming the foremost health problems in urban India. The power to heal and cure comes not from taking medicines, but from right nutrition. This is especially so in the case of obesity and diabetes. We cannot prevent death, but let us learn to eat scientifically while alive to prevent and treat these conditions.

Perhaps it will take Indians another one hundred years to realize the implications of their unscientific eating habits and to comprehend why eating cereals, especially polished cereals like white rice and maida at all

three meals as the main dish, have made half the urban population unhealthy by resulting in obesity and all it’s health related complications.

We are today suffering from the ‘ side effects ‘ of cereals. If we cannot change our traditional eating habits, perhaps we owe it to our children to give them right information and feed them wisely to protect them from the ‘killing fields’ of tomorrow. If we could but restrict ourselves to two fistfuls of pulses for lunch ( preferable pulses and soya ) and a two fistful of cereals ( rice or wheat ) at dinner time, blood glucose levels would not become elevated and we would be able to prevent and treat both obesity and adult onset diabetes mellitus in a large number of cases.

It all began on our 15th wedding anniversary in 1989 when my husband David agreed to drive us to a restaurant for dinner. He was greeted by a gentle nudge on his tummy from the steering wheel of our Premier Padmini which we still have, and decided to do something about his weight right away. There followed a month of experimenting with oil free and calorie restricted diets, but all in vain. Finally he decided to stop eating all high carbohydrate foods and to eat as much as he wanted of low carbohydrate foods. He was delighted to find how comfortable he was. He was eating all the tasty nutritious foods without having to worry about quantities, and the kilos began to drop away. He convinced me to follow his example and I was so happy to have been able to lose all the weight that had insidiously appeared after the birth of my second child.

As we grow older, our metabolism slows down and our activities decrease, so that we need very much less food than before. If we don’t make certain changes in our diet, it is inevitable, that we will put on weight as we grow older.

In this diet no special cooking methods are insisted upon. In fact I would like you go out and buy a whole lot of recipe books since all food types are included in this diet. Since oil and spices may be used, this diet opens up a whole new, exciting experience of tasting and relishing food. In fact no special foods need to be prepared. Its all just about choosing the right food from whatever is available and eating it at the right time, even when you are on tour or on a holiday.

We are not taught in either school, college or even medical college about how to eat scientifically, so that we may prevent the onset of Obesity and Adult Onset Diabetes. Weight Reduction is the first line of treatment in so many medical conditions. We doctors often send our patients away with just “ diet and exercise� written on their prescription and leave it to them to figure out how to change the way they eat, so that they may lose weight effectively and permanently. I have endeavored to explain to you as clearly as possible how to choose the right quality food, based on food values and nutritional requirements. Remember it is not how much you eat but what you eat and for how long you eat, that determines your health.

Dr. V. Mohan M.D., M.N.A.M.S., Ph.D., D. Sc., Diabetologist and Managing Director, M. V Diabetes Specialities Center (P) Ltd, had been closely monitoring the progress of diabetic patients, and who were on this diet. I thank him for writing such an encouraging and inspiring Foreword for this book.

I thank Dr. Su. Thillai Vallal M.D., D.M., (Int. Med.), D.M., (Cardiology) Consultant

Cardiologist

and

Managing

Director

Venkataeswara

Hospital, Chennai, for writing the Introducion to this book. He has taken such an active interest in this diet and has observed for himself the benefits that have resulted from administering it to his patients, who have hyperlipidemia and hyperglycemia. I have in turn learned much from him about the benefits resulting from the intake of various vegetable oils in preventing cardiovascular disease.

Angeline has created endearing illustrations for this book. I hope that they will be imprinted upon the reader’s mind so that certain basic principles and ‘take home truths’ are forever remembered so that they may permanently benefit from following this diet.

I wish to thank my colleagues in the Medical Profession for their wholehearted support to this system and

especially to Dr Nirmala

Jayashankar, Consultant Obstetrician and Gynecologist Apollo Hospital Chennai and Dr Vishwanath J. Consultant Pediatrician Chennai for their continuous interest and encouragement . I also thank Dr Nirmala Jesudasan, PhD, RD (ADA & DC ) Consultant Food and Nutrition Services, Frontier Lifeline Hospital Chennai, who has analyzed the diet and has found it to be nutritionally complete and scientifically correct.

My thanks are due to Miss.R. Shalini M.Sc., Foods, and Nutrition for compiling the Medical references from Medical Journals and Scientific presentations, that lend support to this diet. The results of these clinical trials indicate that a carbohydrate restricted diet is ideally suited to prevent and treat obesity, diabetes mellitus and cardiovascular diseases.

This preface would not be complete without mention of my three doggies, Steffi, Poppy and Candy, who sit by my side in total silence for long hours while I consult. They too eat only non vegetarian food, milk, pedigree and brown bread. If they ate unrefined cereals indiscriminately, they would also become prone to obesity and diabetes.

Many excellent books are available on health, each intending to map out a system that could help overweight people and those with diabetes, to lead a healthier life. I am compelled to admit in all humility, that there is still so much that remains unknown in this field, since each individual’s body has its own distinct metabolism which is the result of genetic, hereditary, environmental, cultural, psychological, hormonal and pathological factors. This is why no one system can be suitable for everyone. This book as been written keeping in mind traditional Indian eating habits. It deals with choosing the right type of carbohydrate and combining it with some protein at each meal. This is what I believe to be scientific and intelligent eating. I have taken all my lessons from nature.

If you follow the principles outlined in this system, you will be truly ‘ eating naturally ‘.

Even though non vegetarian food has been included in this diet, surely a day will come, when many more of us will realize, that as stewards of the earth we should be protecting all living creatures, instead of killing some of them for food, especially when vegetables, fruits, nuts, whole grain and dairy products are abundantly available.

I am profoundly grateful for the inspirations that have expressed themselves through this book. The book is on the net for free because the inspirations came for free.

I dedicate this diet to all those who have come to me in faith and trust and who have gone back fulfilled; especially to those who have Adult Onset Diabetes, for they achieve better glycemic control with reduced dependence on insulin and oral medication.

Dr. Tusna Park

INTRODUCTION Dear Readers, "Choose the diet which is right to lose weight and feel light".

It is the desire of all people, that they should eat healthy, nutritious and readily available food. In my medical practice, I have come across people, who fall into these four categories : • Those with faulty food habits and are confused about what to eat and what to avoid • Those who are ignorant about healthy food habits • Those who eat in a great hurry • those who indulge in modern "Junk foods."

India has the largest number of heart patients in the world today and the chance of an Indian getting a heart attack is 4 times more than an American, 6 times more than an European, 7 times more than a Chinese and 20 times more than a Japanese. Indians under 40 yrs, have a 10 fold higher risk than other nationals. Indian women are as vulnerable to Coronary Heart Disease as men. Even though this is due to a combination of genetic susceptibility and life style changes, it

is also partly due to faulty food habits and hence we need to introduce a healthy diet plan for them.

This book is aimed to help all these people, especially those who are either obese, diabetic or who have high cholesterol and triglyceride levels. The aim of this book is to prevent and treat obesity and all its consequences. Our staple food of rice and wheat is high in carbohydrate, which is associated with obesity, diabetes and cardiovascular disease.

The objective of this book is to show you how you can change the way you eat, so that you can continue to eat high carbohydrate foods like rice and wheat and all your favourite snacks, because you will be taught to eat them in the right quantity and combinations. This diet contains adequate protein, which in the absence of renal disease is at least one gram per kilogram per day and 20ml of visible vegetable oil which contains polyunsaturated and mono unsaturated fatty acids in the right proportion. It also contains the optimum amount of glucose to meet energy needs and does not unnecessarily increase blood glucose levels thus helping to prevent and more effectively treat diabetes.

I have no doubt that this book will be a boon to those who are in search of a way to live healthy lives. It is my wish

that everyone should read this book and benefit from it. As the great poet Thiruvalluvar says, "As pleasure dwells within him who eats moderately, So disease dwells with the glutton who eats voraciously."

Dr. Tusna park, who graduated from CMC Vellore has been practicing in Chennai since 1991 and has helped so many people to lose weight and achieve better glycemic control with her diet, which is scientifically balanced and nutritious. The emphasis is not on how much you eat but on what you eat. How wonderful to be able to eat and lose weight!

I wish you all a healthy and happy life.

Dr. Su. Thillai Vallal, MD., (Int.Med.) DM., (Cardiology) Consulting Cardiologist and Managing Director Venkataesware Hospital Chennai

1

Think About Your Weight, Think About Your Diet Being Aware of Your Weight The incidence of obesity and adult onset diabetes is increasing at an alarming rate in India today. It is not uncommon to see ten-year-old children weighing up to 50 kg, and teenagers weighing from 80 to 120 kg! How have we allowed this to happen to our young people?

Parents, owing to ignorance, overfeed their children in the hope that they will grow up healthy and energetic. They equate love with the meticulous preparation of a variety of foods to stimulate a child’s appetite and are hurt and angry if their labours go untasted. In fact, a large number of overweight adolescents are single children who have been showered with snacks and sweets by their misguided parents and who have had no siblings or pets with whom they could have shared their food.

Children are forced to eat even if they are not hungry. Have you noticed how slowly and deliberately little children eat? In fact, it is because they take so long over chewing and tasting their food, that they are scolded by their impatient parents and are forced to ‘swallow quickly’. Also notice how little children put small quantities of food into their mouth and stop eating when they are full. They are then scolded once again because there is food left on their plates. The parent has decided that a certain quantity of food is necessary for growth and is genuinely concerned and worried if the child eats less. I have seen how little children are forced to eat till they end up not only in tears but feeling sick and deprived of the pleasure of taste and satiety. Children and animals left to themselves would never put on weight. Don’t ignore the fact that your children seem to be overweight by telling yourself that “it is a part of growing up, everything will be all right later on.” Fat deposition is not a part of growing up and it is unhealthy. It indicates an imbalance in the diet. Instead of ignoring it, correct it.

In the last two decades the number of children who are obese has doubled and obesity-related health complications like insulin resistance, coronary artery disease, high blood pressure, diabetes and even cancer, which were once confined to adults, are striking people at younger ages. These diseases start when an obese child is between three and five years old. Unbelievable as it may sound, children as young as ten years have been shown to have insulin resistance, elevated blood pressure and even elevated cholesterol levels. For teenagers the problem could be worse. Significant atherosclerotic changes, which are the dangerous buildup of fat and cholesterol in the arteries that can lead to heart attacks and strokes, have been detected in overweight teenagers. Similarly, Type 2 or adult onset diabetes typically diagnosed after the age of 30 years is also being detected in overweight teenagers. It takes about 15 years for the complications of diabetes to arise, so when diabetes strikes at a younger age the complications of diabetes such as blindness, kidney failure or amputation occur earlier in life. Similarly, it is not unknown to find young people in their forties suffering from coronary artery disease which could subsequently lead to sudden death due to a myocardial infarction. Obese adolescent girls sometimes develop multiple cysts on the surfaces of both ovaries, leading to menstrual

irregularities, hormonal imbalances and infertility. Our unscientific eating habits coupled with stress and sedentary lifestyles have all contributed to a greater prevalence of morbidity and mortality from these obesity-related disorders.

When one begins to eat those foods that nature has provided for us, as you will on this diet, the body receives a greater proportion of fibre, protein, vitamins, minerals and antioxidants than before. Being therefore more nutritionally and scientifically balanced, this diet is ideal even for pregnant and lactating mothers provided of course that their

parents, in-laws and other well-wishers will permit them to eat in this way.

Pregnant and lactating mothers are forced to eat high carbohydrate foods by caring and concerned relatives ‘for the sake of the baby’. The nausea and vomiting experienced by an expectant mother is nature’s way of protecting both the mother and developing foetus from dangerous toxins present in the mother’s diet. It is also nature’s way of preventing obesity in the expectant mother. Giving the mother medicines to alleviate nausea and vomiting and forcing her to eat is therefore harming the developing foetus and going against nature.

With ultrasound facilities available today, doctors no longer need to monitor the growth of a foetus by noting the weight of a pregnant mother. A weight increase of six kilos in an expectant mother who is not already overweight is all that is required to ensure that the baby is growing normally.

We think that if we provide more glucose to the body we will be more energetic. If we fill more petrol into a vehicle, will it go faster? It will not. Similarly, extra glucose provided in the diet due to our overwhelming concern for ourselves does not make us more energetic. Our daily routine of sleeping, sitting and walking is not going to change by giving ourselves more glucose! Simply put, excess glucose is immediately removed from the blood and stored as fat

which in turn leads to a host of health problems such as diabetes, hypertension, cardiovascular disease, arthritis, back problems, cancer, depression, piles and polycystic ovaries which lead to irregular menstruation and infertility.

Frequently, although we are aware of an increase in our weight we do not know what exactly to do to stop the unhealthy trend. There is confusion about what to eat and what to avoid. We try to cut down on quantities, but end up feeling hungry. Then we try cutting out oil and find that it is impossible to cook tasty food without oil. As a result we ignore those early extra kilos and discreetly buy ourselves a new set of clothes, hoping against hope that all will be well. We also begin to take long walks and sign up at a gym, in vain. By now we begin to feel depressed and have begun to lose hope about our condition. If only someone would tell us exactly what to eat and what to avoid, we might say to ourselves, all would be well.

As you go through this book, I want you to begin to understand the science behind fat deposition; to become aware of food values and nutritional requirements and how they affect the human body. I want you to follow the advice given, with a clear knowledge of what you are doing. You must begin to feel good about choosing the right food. You will be eating those foods that nature has intended you to eat and will naturally begin to feel lighter and healthier. You will also not feel hungry and will very comfortably be able to continue on this diet. I hope that each one of you will become a lamp not only to yourself but to others, so that the next generation will be healthier and wiser.

How many of us possess weighing scales and take our weight every day? How many have a height and weight chart and know what our ideal weight should be? Below is a height and weight chart for adults and children. Decide which body frame describes you best. Smallframed people are small-boned with rather narrow hips and shoulders.

Their wrists are narrow and feet are small. Large-framed people are heavy set and stocky with broad hips and shoulders. They have big wrists and feet. If you find that your body falls between these two frames or that you have just about the right build, consider yourself to be medium-framed.

Another useful parameter to decide how healthy you are is by using the Body Mass Index (BMI).

BMI = Weight in kg / Height in metres x Height in metres Normal: BMI between 18.5 and 25 Overweight: BMI between 25 and 30 Grossly / Obese: BMI over 30 A recent article in Lancet suggests that the cut-off points for Asians should be set at between 22 and 25 for overweight and between 26 and 31 for obesity.1

1

Figure 1.1 will help you find your BMI easily if you know your exact height and weight.

If your Waist/Hip Ratio in cm is less than 0.9 for men or 0.8 for women, consider yourself to be healthy. The waist is measured in cm around the navel and the hip around the broadest part lower down. If the ratio exceeds the above values, it means that your body stores more fat in the abdominal region (you are shaped like an apple) and you are more likely than others to suffer from coronary artery disease, hyperlipidemia, hypertension, gout, atherosclerosis and insulin resistance, collectively known as Syndrome X. It has been shown that if overweight people can reduce even 10% of their original weight (while this may not make a significant difference to their appearance), or if they can reduce their BMI by 5 points, they will be healthier than before.

Prevention is better than cure, so start right away. If you find that you either weigh more than you should or that your BMI or Waist/Hip

Ratio are above normal, read on and it will become clear where you have gone wrong with your diet. Don’t comfort yourself by saying that you are growing old gracefully. As you grow older you have to pay more attention to your body, since your movements and metabolism are slowing down and you become prone to so many obesity-related disorders. If you find that you have put on weight, take steps to halt this undesirable trend by first understanding and then following the advice given in this book.

Analysing the Traditional Indian Diet Nutritionists agree that in the absence of renal disease, the human body requires 1 g per kg body weight of protein per day. Children and adolescents require more protein. An average adult Indian weighing 60 kg would therefore require 60 g protein per day. In a vegetarian diet, 20 g per day would be provided from half a litre of milk and 40 g from rice, wheat and pulses. To obtain this 40 g protein Indians have been encouraged to eat 250 g rice, 100 g wheat and 50 g of pulses every day. While providing 40 g protein, these three items alone provide the body with over 350 g carbohydrate per day. To this is added at least 100 g of root vegetables, one fruit, 500 ml milk, six teaspoons of sugar and a sweet, providing an additional 150 g of carbohydrate. An intake of 500 g of carbohydrate per day is today recommended for an athlete and would have suited people when they were engaged in hard physical labour. Today our physical activity has decreased to such an extent that we require only a third of this amount of carbohydrate.

Indians eat cereals and pulses as their main dish three times a day.

One would imagine that no other foods can be found to eat! In fact, if cereals and pulses are not included at a meal, most Indians feel that they have not eaten properly and something terrible will happen to their bodies! Terrible things are happening to the body because of our traditional, deep rooted feeding habits. Indians are finding themselves in the grip of malnutrition in the form of obesity and all its consequent health hazards. Indians must learn to change the way they eat if they want to prevent and treat obesity, diabetes and cardiovascular disease.

Below is the analysis of the traditional Indian diet which clearly indicates how unscientific it is. Look at your plate every time you eat, and you will see that the main dish is composed of either rice or wheat along with pulses. Rice, wheat and pulses are all seeds. Seeds have become the main dish at every meal and all other items constitute side dishes.

Are Seeds Natural Foods?

Now let us consider whether we are doing the right and natural or wrong and unnatural thing by eating so much seed. All that you will learn about healthy and intelligent eating is based on our observation of nature which is truly the world’s greatest teacher! Let us observe what terrestrial animals eat, for they eat whenever they want and as much as they want, and yet appear to be healthier and more active than most human beings. We know that carnivores eat meat and herbivores eat plants. Root vegetables have been placed under ground, hidden from the sight of humans for the more active underground animals who need more energy, for they have to dig. The sweet fleshy fruits have been placed high up in the trees, beyond the reach of humans, for the birds who need rapidly available energy to fly. The fruits that nature has intended humans to eat are placed near the ground and have less glucose in them. They are the tomato, brinjal, ladies finger, drumstick, capsicum and all the gourds. But we call these fruits vegetables because they are not sweet. We do not require the extra glucose from the sweet fleshy fruits which we continue to relish in addition to all the other foods that we include in a meal. In ancient India, it was known that a diet consisting of roots and fruits would lead to fat deposition. The sage Vyasa in the Mahabharata causes Karna to tell Bhima during the Kurukshetra war, “Go to the jungle, fill yourself with fruits and roots and grow fat!�

How marvellously nature has placed food in the locations that allow species that have natural access to them to receive the optimum amount of glucose for their energy requirements! Humans walk on land. They neither have to dig nor fly and yet humans eat both roots and fruits. People also cook and eat seed as their main dish three times a day. No animal in nature eats so much seed. If an animal eats seed, it is ingested raw and passes out of the body undigested and unabsorbed to fall into the ground and give rise to a new plant. This is why nature has packed so much carbohydrate into seeds. By moving to a seed-based diet, humans have gone completely against nature, and we are today experiencing the ill effects of our unscientific eating habits.

How did it come to be that the eating habits of humans have evolved (or developed) into a seed-based diet? When human beings were nomads wandering from place to place they did not eat seeds, for seeds do not grow naturally in the wild in large quantities. They have to be cultivated. Our nomadic ancestors were mainly gatherers of plant foods. Occasionally they also supplemented their diet with hunted meats. When people settled down they found it more convenient to grow crops for food than to hunt and gather it on a daily basis. The fact that seeds can be stored without refrigeration makes

them a convenient food and resulted in people adopting a seed-based diet. Seeds also served to protect people against famine and drought since they could be stored for long periods of time. All these factors resulted in making seeds an indispensable and important part of the diet of human populations. This has led to people cooking seeds and eating them as the main dish three times a day.

Some Facts About Indian Food Habits By and large, Indians use the wrong quality of oils which results in an imbalance between HDL (good) and LDL (bad) cholesterol, thereby predisposing them to cardiovascular diseases. The Indian diet also contains insufficient protein which upsets the balance between insulin and glucagon, resulting in more fat-producing insulin which also lowers HDL and increases triglycerides. Antioxidants, which are found in vegetables, fruits, nuts, beans and legumes, are not found in sufficient quantities in the Indian diet. Antioxidants prevent cardiovascular disease and cancer. Antioxidants also enhance the immune system and protect us from the harmful effects of pollution, pesticides and aging.

The Traditional High-Carbohydrate Diet and its Effects Both obesity and adult onset Type 2 diabetes result directly from the intake of large quantities of high carbohydrate foods, which are converted to glucose by the digestive process and subsequently absorbed into the blood. Glucose is to the body what petrol is to a vehicle. Just as there are different types of engines that require different amounts of petrol and this also depends upon the size age, maintenance and usage of the vehicle, similarly certain constitutions utilise more glucose while others utilise less. This is where we have erred in our basic understanding of nutritional requirements. The criteria mentioned in all calorie requirement charts relate only to different levels of human activity. It has not been understood that two people with identical lifestyles may have different capacities to utilise glucose.

About 40% of the adult urban population can be compared with the old engines that burn up excessive amounts of petrol. These fortunate people eat whatever they wish to and do not become overweight.

The other 60% are however not so fortunate. Our appearance, nature and constitutions are genetically determined and outside our control. We have failed to recognise these inherent differences in our metabolism and all of us eat the same quantity and quality of food.

Most people’s bodies are unable to utilise the excess glucose absorbed from their high carbohydrate diet. Simply put, after insulin has facilitated the entry of glucose into cells to produce energy, and has produced glycogen which is stored in the muscles and liver, excess glucose is stored as fat. In those prone to diabetes due to a family history of the disease, blood glucose levels are elevated, since they either do not produce enough insulin, or their bodies are resistant to insulin.

The Indian diet contains over 80% carbohydrate by weight. The average urban Indian adult, who is not involved in hard physical labour and who shows a tendency to put on weight, cannot utilise so much carbohydrate and what cannot be used gets stored as fat. Our ancestors led more active and healthy lives than we do today. They had more regular and disciplined eating habits, rarely ate out and indulged in sweets only on special occasions. So, by and large, their diet and activity were finely balanced. Today we have become mentally more active, and this at the expense of physical activity.

Worse still, we eat unscientifically. We have used our intelligence to put ourselves on the moon, but we have not used it to put the right food into our mouths. Why is it that we have used science to benefit ourselves in every field of life but we have not learnt to eat scientifically?

When I talk about carbohydrate I want you to think of glucose.

Simply put, all carbohydrate, simple and complex, is converted into glucose by the digestive enzymes in the mouth and the small intestine.

This glucose is then absorbed into the blood. Seeds are ‘trick foods’, because they do not reveal their true nature on the tongue. Since they contain complex carbohydrates, they do not taste sweet in the mouth and we are therefore deceived into thinking that they do not contain significant amounts of glucose and are therefore harmless. The fact is that digested cereals and honey contain almost the same amount of glucose!

Honey on the other hand reveals itself. It is sweet and it is therefore consumed in small measured quantities. Honey, rice and wheat contain 79%, 78% and 72% glucose respectively. All three contain almost the same amount of glucose and yet we measure out honey carefully in teaspoons while we measure out rice and wheat by the cupful ! While our monthly provisions may include a small bottle of honey, we unfailingly order rice and wheat by the sackful ! Since sugar contains 99% glucose, rice and wheat contain only 21% and 27% less glucose than sugar. It is ironical that those who have diabetes cut out a few teaspoons of sugar from their diet but eat the equivalent of at least 10 teaspoons of sugar at each meal, three times a day, by continuing to eat rice and wheat. One may avoid eating all ‘ sugary ’ foods but still be receiving over 30 teaspoons of ‘ hidden ’ sugar from cereals and pulses which are consumed as the main dish at every meal in our traditional diet.

Rice contains 78% carbohydrate and wheat 72%. There is only a 6% difference in carbohydrate between rice and wheat. This is why when people stop eating rice, and eat chapatis instead, hoping to lose weight, it does not happen. Rice is urban India’s number 1 junk food! It has the highest percentage of carbohydrate, the least amount of protein (only 7%); worst of all, we eat it in the polished state, in which, even the little fibre and vitamins it has, are also lost. Even though wheat contains almost the same percentage of carbohydrate as rice, it is a healthier food since it contain 12% protein and fibre. Ragi and jowar contain 72% carbohydrate and the other millets, which consist of all the small seeds, like bajra, barley and corn, contain 68% carbohydrate.

All the pulses contain from 58% to 60% carbohydrate. Most of us know that pulses contain 20% protein but very few are aware that they contain three times as much carbohydrate. So, from rice or wheat and pulses, which are present on our plate at all three meals, we receive an average of 70% carbohydrate from these two items alone. Then we add to our diet, sugar which has 99% carbohydrate and we add sugar to sweets, chocolates, ice creams, biscuits and soft drinks. Added to these foods are fruits, root vegetables, peanuts, coconuts and cashewnuts which contain about 25% carbohydrate. This reveals that

a normal or regular Indian diet contains well over 80% carbohydrate by weight.

The Glycemic Index (GI) of rice is 72; of maida, 70; of whole wheat, 69; of basmati rice, 59; of pulses and of beans, 30–40; of soya; 18.

The glycemic index of a food denotes its power to raise blood glucose levels, compared to the power of pure glucose. Studies on animals have shown that foods with a high glycemic index destroy the islet cells in the pancreas that produce insulin. This might explain why India (whose people are almost addicted to polished rice, refined flour and sugary snacks) is now the diabetic capital of the world. Eating foods with a low glycemic index will prevent a rapid increase in blood glucose and consequently less insulin to convert excess glucose into fat. These foods are also more filling and contain more fibre.

If we were supposed to eat a high carbohydrate diet and remain healthy, nature would have seen to it that normal blood glucose levels were much higher than they are. Normal glucose levels are exceeded on a high carbohydrate diet, resulting in obesity and sometimes diabetes.

Energy Glucose has only one function and that is, to provide energy for the body. We should consume just enough glucose to provide adequate energy and to keep blood glucose levels within normal limits. Think of the body as a factory and its organs as the machinery, manufactured to function efficiently at an optimum speed. These machines if overworked will certainly run into trouble. Giving the body three times more glucose than it actually needs, necessitates more energy for digestion, absorption and metabolism. The final result is fat deposition!

The body has unnecessarily increased its energy expenditure by three times on these metabolic processes, all for nothing! Energy has been wasted and the body’s internal organs have been overworked. This is why we feel tired and drowsy after a high carbohydrate meal.

The typical Indian breakfast and lunch contain large quantities of high carbohydrate foods which stimulate insulin secretion. High insulin levels rapidly lower the blood glucose and we begin to feel tired and drowsy about two and a half hours later. Notice how coffee or tea unfailingly make their appearance at the workplace at 10.30 a.m. and 3.30 p.m. These beverages contain stimulants and sugar to counteract the hypoglycemia and we immediately feel more alert and active.

When you begin to eat the food that nature has intended you to eat, energy is not wasted, it is conserved, and you begin to feel more energetic than before. Take care of your body. It is your vehicle. If you are particular about the quality of petrol and oil that you fill into your car or two-wheeler, how much more particular you should be about the quality of food that you put into your mouth. Put the right food into your mouth as nature has intended for you and you will be healthy and free of disease.

Before you put any food into your mouth think about what it contains. Based on the information I have given you about the carbohydrate content of all foods, think and plan before you eat. Ask yourself if you are putting food of the right quality into your mouth. Eat scientifically and, intelligently. If nature intended you to eat large quantities of seeds and sugar which provide the body with three times

as much glucose as it needs, normal blood glucose levels would have been three times higher than they are and obesity or diabetes would not exist.

If we could restrict our intake of seeds to two fistfuls of seed at lunchtime and two fistfuls of seed at dinnertime, blood glucose levels would not be elevated and we would, in fact be able to prevent and treat obesity and Type 2 diabetes more effectively.

Unfortunately, on a high carbohydrate diet, insulin levels are high.

Insulin increases the LDL (bad) cholesterol and triglyceride levels while decreasing the HDL (good) cholesterol levels in our blood. In addition, high levels of insulin may also increase the risk of clot formation and would also increase blood pressure. Additionally, insulin also brings down our blood glucose level and as it falls, we begin to feel hungry and want to eat again. We are controlled by insulin on a high carbohydrate diet and have no control over hunger. As a result, not many people are able to adhere to a low calorie, high carbohydrate diet, which is why it becomes so difficult to lose weight and then consequently maintain the weight loss, on such a diet.

The Ideal Diet The ideal diet should be based upon principles and not on a diet chart.

The underlying principles of this diet are as follow: 1. Plenty of vegetarian and non-vegetarian food along with two fistfuls of seeds (preferably pulses and soya) could be eaten at lunch time and two fistfuls of seeds (cereals) could be included at dinner time.

2. Vegetable juices, raw vegetables, fibrous fruit, buttermilk, rasam and lime juice with salt, may be taken along with either a few almonds, pistachios, walnuts, a fistful of groundnuts or roasted soya nuts from morning till lunch and again between lunch and dinner.

3. Two flat teaspoons of sugar may be used to sweeten a drink once on rising in the morning and once more in the evening.

For a diet to be perfect it must be tasty and should not reduce one to a state of constant hunger. A diet should also be practical in that it should be possible to follow not only at home but also when eating out. In addition, you should not have to count calories and no special cooking methods should be insisted upon.

For a diet to be nutritionally sound it must provide not only adequate protein, but also the correct amount of carbohydrate to meet energy requirements while keeping blood glucose levels within the normal range. It must also contain the right quality and proportion of monounsaturated and polyunsaturated vegetable oils, to maintain the correct ratio of HDL and LDL. It must also contain fibre and all the vitamins, minerals and antioxidants that the body needs. The diet should contain at least 20 g of fibre. Whole grain, nuts, legumes, pulses, fenugreek, vegetables, fibrous fruit, psyllium husks and bran are rich in fibre.

When mixed and fermented along with rice and pulses to prepare idlis and dosais, the roasted soya bean is an ideal constituent of a healthy diet. Even though it is a seed, its carbohydrate content is low ( 20 to 30% depending upon the variety ); it contains a high quality protein ( 35 to 40% ); its oil is best suited to lower LDL cholesterol ( 20 to 22% oil ) and it is packed with vitamins and minerals. It is consumed in the unpolished state unlike rice and wheat, in both of which the nutritious germ is removed in polishing.

The ideal diet should contain plenty of antioxidants like fresh fruits, vegetables, nuts, tea, pulses, legumes, soya and vegetable oils to protect us from the harmful effects of free radicals, atmospheric pollutants, pesticides and cigarette smoke which combine with cholesterol and other cells in our body, making us predisposed to cardiovascular disease, cancer, a depressed immune system and the effects of aging.

It is universally believed that fat in the body results from too much oil in the diet and overweight people therefore begin by avoiding oil, eggs, deep-fried and non-vegetarian foods. It is only when they do not find a significant change in their weight that they realise that they were probably wrong and that some other factor is the main cause of their

weight gain. The ideal diet should contain 40 ml of oil. Of this, 20 ml is invisible oil that is contained within the food that we eat and 20 ml is visible oil, which is used for preparing food. Use a maximum of 600 to 750 ml of oil per adult per month and no extra oil will be available for the body to be converted into fat.

Protein is required for tissue repair among many other functions.

Protein requirements are therefore calculated depending upon how much tissue there is on the body, which is your weight. Adults need at least one gram of protein for one kilogram of body weight. Children and teenagers require more protein. This diet provides you with the correct amount of protein and there will be no extra protein in your diet which will convert into fat.

Glucose is needed for energy requirements. This is where the Indian diet is unscientific, for it provides the body with about 200 to 300 grams of excess glucose which is removed by insulin in the body and converted into fat. This diet provides the body with the correct amount of glucose to meet energy requirements while it also keeps blood glucose levels in the blood within normal limits.

Vitamins, Minerals and Antioxidants Most food items contain trace amounts of vitamins and minerals.

Table 4.1 provides information on those low-carbohydrate foods that contain significant amounts of both, to meet nutritional needs.

Dark green leafy vegetables (DGLV) include not only the conventional greens, but also the leaves of root vegetables (carrot, turnip and radish leaves) and the leaves of certain trees and shrubs (drumstick leaves). In addition to beta carotene (precursor of Vitamin A), Vitamin E, K, calcium, iron and other minerals, which are not affected by cooking (heat), DGLV also contain Vitamins B and C which, being water soluble, are destroyed by heat. A good idea would be to cut DGLV fine and mix them into a mixture of soya and whole wheat flour when preparing dough for chapatis. DGLV contain a high percentage of oxalates (700 mg) which is why they are traditionally eaten only during the day, since it is feared that eating them at night may cause the oxalates to be deposited in the urinary tract as stones.

But nature has its own safeguards: food with a high percentage of oxalate also contain a high percentage of calcium to bind the oxalate.

This prevents calcium oxalate from being absorbed into the bloodstream. One need not therefore be afraid to eat foods that contain a high percentage of oxalate.

Orange, red and yellow vegetables and fruits are rich sources of beta carotene and Vitamin C. Fruits and light green vegetables like cucumber, cabbage, broccoli and brussels sprouts are good sources of Vitamin C, water and minerals.

All these fruits and vegetables are antioxidants. The leaves of root vegetables are natural diuretics, while tomatoes, cabbage and most fruits are natural alkalisers.

Vitamin D is not found in the vegetable kingdom, but it is formed naturally by the effect of sunlight on seven dehydrocholesterol under the skin. Vitamin E is found in DGLV, nuts, whole grain and vegetable oils. Egg white, soya and milk contain all the essential amino acids.

Vegetable oils contain all the essential fatty acids.

Some commonly used vegetables are extremely useful. For instance, raw onions lower LDL cholesterol. They are also antiinfectives, anticoagulants and aphrodisiacs. Raw garlic also lowers LDL cholesterol. It is anti-infective and is said to increase the secretion of milk. Dry ginger is anti-inflammatory and analgesic which is why a hot drink with dry ginger in winter might help to relieve pain from stiff and swollen joints. Cauliflower, broccolli and brussels sprouts protect the body against cancer.

All the above foods contain vitamins and minerals in organic form so that they are readily absorbed into the blood. The diet described in this book does not recommend the ingestion of vitamins and minerals in inorganic form as is found in tablets.

Eating Your Way to Health The ideal diet should contain the following: – 20 ml mixed vegetable oil: sesame (till or gingely), groundnut, ricebran, olive or mustard oils

– 100 g red, orange or yellow fruit and vegetables like tomatoes, carrot, beetroot, papaya, pineapple or orange – 100 g light green and white vegetables like cabbage, cucumber, chow chow (squash), broccoli, brussels sprouts, radish, turnip, onion or garlic.

– 100 g dark green leafy vegetables – 200 g other vegetables which may be lightly cooked – 500 ml skimmed milk for tea or coffee and curd or paneer – A tablespoon of sesame seeds which contain calcium Choose any two of the following: a) 25 g soya bean b) 50 g pulses preferably with the husk c) 50 g whole grain2 – wheat, popcorn, oats or millets (corn, bajra, jawar), unpolished or basmati rice d) 15 g nuts – groundnuts, almonds, pistachios, walnuts and coconut e) 50 g home-made paneer or 100g tofu Vegetarians may also occasionally use a teaspoon of butter or ghee and non-vegetarians may add either chicken (without fat or skin), fish, shellfish or egg to their diet.

Saturated fat in the diet stimulates the liver to produce LDL (bad) choleserol. It is found in significant quantities in cream, butter, ghee, cheese and paneer which are bought rather than made at home, visible fat and skin on meat, in organ meats, coconut oil, palm oil, vanaspati and other hydrogenated fats and margarine. You are therefore advised to indulge in these foods only occasionally. Do not use the same oil repeatedly for deep frying since heat hydrogenates the oil to form transfatty acids which also increase LDL levels.

2

‘Whole grain’ refers to unpolished rice and wheat. It also includes pulses with bran, oats and popcorn.

VITAMINS, MINERALS AND ANTIOXIDANTS

VITAMINS

Dark Green Leafy Veg

Orang e, Red Other & Vegetab Yello les w Veg

Nuts

Whole grain Germina which Soya ted contains bean pulses the bran & germ

3

VITAMIN A BETA CAROTENE ( Precursor of Vitamin A )

VITAMIN B1 (Thiamine)

B2 ( Riboflavin)

Cream, Liver, Paneer Skimm Meat & Egg Butter ed milk Seafoo & ghee d

3

3

cau, bro, br. sp, coconut cab, cap, on

3

coconut capsicu , m ground nut

3

almond s, coconut

3

yellow corn

3

3

3

fish liver oils

apricot

yeast, bengal gram

3

3

3

Others

3

3

beer, mutton, synthesized chicken in large

intestine NIACIN

3

B6 (Pyridoxine )

3

ground nut beans

3

3

ground nut

3

3

yeast

3

liver

yeast

3

3

sea weed, synthesized in large intestine but not absorbed

3

fish, liver

3

liver

yeast

3

liver

yeast

B12 ( Cyanocobalamin e)

FOLIC ACID

3

only tomat spinac o h

lad.fin, cuc beans, peas

ground nut

pulses

PANTOTHENIC ACID

3

BIOTIN VITAMIN C

3

tomat cap, cab,

esp

pomegranat

o

cau, bro

green gram

e, melon, lime, amla, guava 3

VITAMIN D

VITAMIN E (Tocoferol)

3

VITAMIN K

3

VITAMINS

3

tomat o

3

3

cau

Dark Orang Green e, Red Other Leafy Vegetab & Veg les Yello w Veg

3

Nuts

Soya Germina bean ted pulses

Whole grain which contains the bran & germ

sun’s rays

3

liver

3

liver

Cream, Skimm Egg Liver, Meat & Paneer ed milk Seafoo Butter d & ghee

vegetable oils

Others

MINERALS & ELEMENTS CALCIUM

3

carrot

cab,

ground

3

pulses

paneer

3

3

fish

Sesame

Seeds

nut, beans, bro, br. almond s& sp, cap, coconut on

IRON

SODIUM CHLORIDE

3

3

POTASSIUM MANGANESE PHOSPHOROU

cuc, cab

3 3

3

pulses

beef

Coconu t

3

paneer lettuce, gar

IODINE CHROMIUM

ground nut, cab, almond beans s, coconut

3 3 3

paneer tomat cucumbe Coconu o r t 3 carrot Cucumb almond

3 3 pulses

fruit, lime

3

lime 3

fish,

S SILICA

er 3

s

meat

onions

FLUORIDE

cau, cuc

Pistachi os

3

SULPHUR

cab, on, Coconu ra t

3 3

ZINC

on, gar, cuc, cab, cel, bro

SELENIUM

MAGNESIUM

COPPER

3

fish

cucumbe Coconu r t beans

cau, bro, br. sp

3

fish

3 Coconu t

LECITHIN, CHOLINE SULPHORAPHE NES & INDOLE – 3 CARBINOL

yeast

3

3

3

mushroom, yeast berries

liver, fish

fruit

liver

yeast

FIBRE > 10 mg

Peas, beans

3

3

fenugreek

Bro: broccoli, Br.Sp: brussel sprouts, Cab: cabbage, Car: carrot, Cap: capsicum, Cau: cauliflower, Cuc: cucumber, Gar: garlic, On: onion, Lad. Fin: ladies finger.

2

General Information Most people are not aware, that even though we may drink healthy liquids and eat raw vegetables with low carbohydrate fruits and some healthy nuts or protein rich foods, every two hours till lunch, we only need to sit down for a carbohydrate restricted meal twice a day. This will automatically result in fewer calories and lower amounts of salt and oil in the diet. We should return to our ancient Indian tradition where it is believed that prolonged rest to the digestive system every day benefits and energises the body. Eating a heavy high carbohydrate breakfast is a Western concept. It neither energizes the body as is commonly believed (in fact it makes one feel tired and hungry two hours later due to hypoglycemia or low blood sugar resulting from a spike in insulin secretion) nor does it prevent gastritis from developing. The main etiological factor for gastritis is stress or infection and not the absence of eating a high carbohydrate breakfast.

Gastric secretions including hydrochloric acid are produced in response to food in the mouth. An empty stomach is not filled with acid, corroding away the gastric mucosa, as is commonly believed.

Avoiding a high carbohydrate breakfast is one of the most important factors in preventing obesity and diabetes. Due to higher cortisol secretions in the morning, the body is resistant to insulin at this time of the day. This means that glucose less readily enters the cells to be stored as energy, resulting in higher blood glucose levels and more glucose being stored as fat..

Liquids These are the liquids that you may drink from the time of rising till noon, and again between lunch and dinner. : two cups of coffee or tea with a little milk and sugar; a glass of any malt drink such as Ovaltine, Milo, Bournvita etc without sugar; tomato juice made from two tomatoes; lime juice; buttermilk; a glass of coconut water; rasam; vegetable juices or soups.

Coffee versus Tea Most of us would like to roll out of bed in the morning and head straight for a steaming cup of either tea or coffee. Both are stimulants—coffee more so than tea. Caffeine from coffee is habitforming and exerts its vasoconstrictive effects on the heart and blood vessels, which is why those with low blood pressure feel so much better after a strong cup of coffee. However, caffeine hinders the absorption of calcium and also prevents sleep. It would therefore be prudent to restrict yourself to drinking one cup of coffee perhaps, in the morning, and switch over to tea in the evening. Those who would like to drink coffee in the evening could use decaffeinated coffee. Tea contains tannin and should never be prepared in an aluminium vessel.

A dash of milk would however precipitate the tannin. Tea, especially green tea is an antioxidant and might also help prevent certain cancers.

Water Drink water when you are thirsty. Do not drink it because you have been told or have read somewhere that the body needs eight glasses of water per day. Let us always observe nature to find out whether what we do or say is right. Is any animal told how much water to drink ? They drink when they are thirsty and not otherwise and they do not as far as we know suffer from urinary tract infections or pimples ! Keep in mind that 60% of all the food we eat in this diet contains water and you will be drinking so many healthy liquids in between meals; so this diet provides the body with enough water. However, if you are not eating a lot of raw vegetables and fruits you may need to drink about two glasses of water every day even if you are not thirsty, since the process of cooking dehydrates food. If you find that you are constipated, then it may be an indication that you need to drink more water. Do not drink water while eating, since it will dilute the digestive enzymes present in your mouth and stomach. Always drink water either half an hour before a meal or two hours after a meal.

There is no such thing as a ‘ detox diet ‘. Our kidneys work from the day we are born to the minute we die ( in fact from the womb to the tomb ), clearing the blood of metabolic waste.They don’t need extra water to accomplish this. Loading it with extra fluid serves no useful purpose. The kidney is like a strainer; Increased input of fluid leads to

increased output. In fact too much water leads to a condition where sodium levels drop and may lead to vascular collapse Tomato Juice Blend two large tomatoes in a mixer with a little lime, chat masala, or a pinch of salt and pepper. Pour it out without straining it. Sip the thick juice slowly so that it fills your stomach; this juice provides you with your daily requirement of Vitamin C and is a natural alkaliser when absorbed into the blood. If you are convinced that the seeds of the tomato will lead to stones in the kidney (which they will not), remove the seeds before using the tomatoes. In fact, since tomatoes are blood alkalisers and contain only four mg of oxalic acid (green leafy vegetables contain over 700 mg) they actually prevent the deposition of minerals in the urinary tract. Tomatoes are excellent antioxidants and contain beta-carotene and chromium that makes cells more sensitive to insulin. In addition, they are low in carbohydrate content.

Tomatoes also contain lycopene which is said to prevent many cancers. We call a tomato a vegetable, but it is really a fruit and the healthiest of them all !

Coconut Water One glass of tender coconut water contains the equivalent of two teaspoons of sugar. So drink it in place of tea, coffee and sweetened drinks either in the morning or evening. You may, as in the case of fruits, replace a complete meal with tender coconut water and also eat the tender coconut, combining it with some protein, as will be explained later. Coconut water contains electrolytes which restore the acid alkali balance in the body.

Milk Milk is a complete food and it is therefore meant for those who have no teeth to chew with, like infants, young children, the old and the infirm. Again let us learn from nature: although adult animals do not drink milk they do not suffer from calcium deficiency. Milk has lactose and casein in it. The enzymes to digest them disappear from the intestine as a child begins to eat solid food. Does this itself not indicate

that nature has not intended humans to drink milk? Ayurveda teaches us that mucus is formed from the undigested milk, which leads to sinus and breathing problems. Besides, today, hormones are injected into cattle to improve the yield of milk. These hormones are secreted into the milk we drink and may cause disturbances to the body.

Taking all this into consideration, you are advised to restrict the amount of milk you use. Curd is better than milk, since the indigestible lactose is converted into lactic acid. Curd also augments the growth of beneficial bacteria in the large intestine. So use curd and buttermilk instead of milk. Paneer or cottage cheese is also better than milk for much of the lactose and indigestible casein is removed in the whey which is discarded. It is also rich in calcium and protein. By making it at home from low-fat milk, cholesterol levels are also kept low. This diet allows you to consume 500 ml of low-fat milk every day. Two hundred and fifty ml would be used for two glasses of tea or coffee and 250 ml could be made into curd or paneer.

Soft Drinks One bottle of soft drink (325 ml) contains about eight teaspoons of sugar. Three bottles would provide enough glucose to supply energy to the body for one day. Any additional carbohydrate in the diet would then be converted into fat. Additionally, soft drink ingredients combine with calcium in the diet to prevent its effective absorption into the blood. You may therefore only occasionally, at mealtime, drink half a bottle of any cool drink (170 ml), combining it with foods that contain predominantly protein, as will be explained later.

Cane-sugar We have gone completely against nature by extracting sugar from sugar-cane and using it indiscriminately in sweets, ice-creams, chocolates, biscuits, cakes and drinks. The only advantage that jaggery has over refined sugar is that it contains iron. Refined sugar contains 99% glucose and jaggery contains 95%. Restrict the intake of sugar to four teaspoons a day. Once a week go out to eat your favorite sweets, chocolates, ice-creams or milk shakes. Ensure that you do not keep these foods at home where you will see them and will be tempted to eat even a little every day. If someone presents you with sweets, generously distribute them to all around you so that the box is emptied on the same day. You may occasionally eat 50 g of sweets and combine them with predominantly protein foods at dinnertime. If we understand that sweets are like poison for the human body we would stop poisoning ourselves and others!

Sugar Substitutes Since the body benefits from a small quamtity of simple sugar twice a day, once in the morning and once in the evening, which is usually mixed into a liquid such as tea, coffee, lime juice or lassi, the use of sugar substitutes has not been encouraged. However, many diabetic patients would prefer to use a substitute in which case they may use levulose.

Levulose Levulose, a low glycemic natural sweetner (GI23), found in centain fruits, being 1.7 times sweeter than sugar, containing 4 calories per gram and not requiring insulin for its metabolism, could be a healthy substitute for sugar.

Aspartame Aspartame is comprised of phenylolonine, methanol and asportic acid.

It is therefore a chemical sweetner and is artifical. The Aspartame Consumer Safety Network has received many complaints about the above effects possibly related to aspartame.

Stevia Stevia is extracted from a plant called Stevia rebaudiona. Complaints from users such as the blurring of vision, aching heads, depression and other neurological disturbances could be related to the long term usage of aspartame. Conclusive data are not yet available and in the circumstances, it is best to avoid a chemical sweetener, especially since there is now a controversy surrounding their use.

Honey Ayurvedas allow the use of honey (which contains 79% glucose) instead of sugar. Since we usually use sugar in tea and coffee, do not add honey to your diet. If you do not drink either tea or coffee, you may use four teaspoons of honey every day: two in the morning and two more in the evening.

Honey and lime is not a magic potion to lose weight. In the Ayurvedic system it is used as a substitute for coffee or tea with sugar.

Since lime is acidic it changes the pH in the pharynx and may predispose us to infections of the throat. On the other hand honey is an antiseptic which is added to lime juice to prevent these infections.

As mentioned above, rice contains 78% glucose and wheat 72%.

Cooking a cup of rice or making 4 chapatis from a cup of wheat is

therefore like drinking a cup of honey. Everyone knows that honey is sweet and would hesitate to drink a cup of it, but we do not hesitate to eat a cup of rice. No one realises that the glucose content of rice, wheat, ragi and honey is almost the same! Millets have only 11% less glucose than honey.

Vegetables Vegetables are our natural food. Yet very few people are aware that vegetables contain carbohydrates. When asked what they contain, most people say that vegetables contain vitamins, minerals, antioxidants and fibre but never carbohydrate! Recollect your first lesson in botany on photosynthesis when you learnt how sunlight is trapped by the chlorophyll in leaves to make carbohydrate and then consider what herbivores eat in nature. The deer eats only grass, stems and leaves and runs swiftly. It does not eat rice, wheat or pulses to get energy. How foolish we are to think that stamina depends on eating seeds! The excess glucose found in seeds is converted to fat, because the body cannot use it. The carbohydrate content in plants suits the energy needs of land animals. If we eat plants we will get the correct amount of energy for our activities and blood glucose levels will never cross normal limits. Avoid eating large quantities of root vegetables along with other vegetables since they contain more carbohydrate. You may however eat radish, turnip, onions, ginger and garlic. Avoid unripe banana while continuing to eat the banana stem and flowers. All other vegetables may be eaten in plenty.

Antioxidants are found in flavonoids (contained in dark green vegetables, herbs, onions, broccoli and tea), carotenoids (in orange and red fruit and vegetables), Vitamin C, Vitamin E (in vegetable oils and nuts) and in many minerals. These antioxidants combine with toxic wastes in our body called free radicals and prevent them from oxidising LDL (bad) cholesterol and triglycerides, which would then block our arteries. Antioxidants thus protect us against coronary artery disease. Antioxidants also protect us against the harmful effects of pollutants and pesticides, which might enhance the risk of cancer, depress the immune system and enhance the aging process.

Vegetables also contain fibre which binds cholesterol in the gut, thus decreasing its absorption into the blood. Fibre also protects us against cancer of the colon, and releases glucose into the blood slowly.

Green leafy vegetables are the best food in the world. They contain carbohydrate, protein, vitamins A, B and C, calcium and even iron.

They also contain omega 3 fatty acids which help to prevent

cardiovascular disease. Since leafy vegetables also contain high levels of oxalate, this calcium may not be completely absorbed. As mentioned before, all other vegetables like ladies fingers, brinjal, drumstick, capsicum, beans and the watery vegetables are really fruits, but, because they are not sweet, we call them vegetables!

Nature has provided us and land animals with these fruits that have less glucose in them, while sweet fruits containing fructose are meant for birds and climbing animals who need more energy for flying, jumping etc. Tomatoes, cucumber, cabbage, chow chow (squash), capsicum, onion, lettuce, turnip and radish may be eaten raw as a salad or mixed with curd and eaten as raita. All other vegetables and mushrooms may be seasoned and cooked in oil as you would normally do using all the spices and masalas to make them tasty. You may eat as much of them as you like.

Fruit Fruits contain beta carotene, Vitamin C, minerals, antioxidants and fibre. Do not drink fruit juices, since we lose the valuable fibre that fruits contain. Without the fibre glucose will rapidly enter the body resulting in a sharp elevation of blood glucose levels and the excess glucose will convert to fat. Eat fibrous fruits like apple, pomegranate, pineapple, orange, sweet lime (mosambi or sathukudi), pear and watermelon. Notice how these fruits which grow within arm’s reach contain moderate amounts of fructose, while those that are found high up in the trees contain high levels of fructose, for example, the mango, banana, jackfruit and custard apple. People often put on weight in the mango season. Of the fleshy fruits the papaya and guava are safest.

Two big mangoes a day contain enough glucose to provide energy to the body for the whole day and anything else eaten is converted to fat!

When you cut a mango, give the sides to other members of your family who are not overweight. Suck on the seed or better still, the inside of the skin that covers the seed. Remember, what is important is that you savour its flavour in your mouth, not how much you put into your stomach. A good idea would be to make a milk shake out of a small portion of the sweet fleshy fruit and have it as a complete meal.

You may replace a whole meal with two small fruits, a fistful of healthy nuts and a glass of buttermilk. Do not drink fruit juices from tetrapaks between meals, even though they are labelled ‘no added sugar’. The

fruit itself contains sugar. If required you may drink, at mealtime, one tetrapak of fruit juice, while eating foods that contain predominantly protein, as will be explained later.

Nuts Almonds, pistachios and walnuts and soya nuts are low carbohydrate nuts and would make ideal presents on festive occasions, for their oils contain predominantly monounsaturated and omega 3 fatty acids that help to elevate the good cholesterol and lower the bad cholesterol.

Nuts also contain fibre, folic acid, potassium, magnesium and natural Vitamin E, an antioxidant that prevents cholesterol from getting deposited in the blood vessels. If you wish you may eat a fistful of these nuts with a vegetable or fruit salad as a complete meal. Avoid eating more than 15 g of peanuts and cashewnuts per day since they contain about 25% carbohydrate in them. A fistful of mixed nuts every day (walnuts, almonds, pistachios, soya nuts and coconut) would provide you with a rich supply of vitamins and minerals. Flax seeds are excellant to eat because they contain Omega 3 fatty acids and reduce LDL levels.

Alcohol Drinking one to one and a half pegs (60 to 90 ml) of whisky, gin, brandy or rum, 325 ml of beer or 150 ml dry wine every day has been shown to help control hypertension, increase the HDL, prevent inflammation, improve insulin sensitivity and prevent blood from clotting in the arteries. All these factors protect the body against heart disease. However, this information should not encourage nondrinkers to begin drinking! Women should limit their alcohol intake to 45 ml a day. Beer contains carbohydrate and should be avoided when trying to lose weight. If you enjoy drinking beer, drink a maximum of 750ml which will replace high carbohydrate foods like rice and wheat at that meal.. Since beer contains carbohydrate no additional carbohydrate foods should be eaten at that meal. A bottle of beer (750 ml) will provide about 300 calories and 28 g of carbohydrate .Beer has been found to elevate HDL levels. One peg of hard liquor provides the body with about 130 calories. These are empty calories since they contain no nutrients, not even carbohydrate, so blood glucose levels

remain unaffected. But these are the calories that the body will use first for energy and those that come from food later will, in all probability, turn into fat. French wine, more specifically Bordeaux wine, contains a substance called resveratol, that actually helps to raise the HDL (good) cholesterol; purple grapes have similar properties; both are excellent antioxidants. The French drink wine (elevates their HDL), eat cheese (high protein and low carbohydrate), add plenty of healthy oils to their diet (which also elevate HDL levels), enjoy their food (which consists of mainly salads, vegetables, fruit and non-vegetarian food) and hardly exercise; yet they are among the healthiest people in the world!

Salt Notice that no animal in nature eats salt from the sea. If an animal finds the need for salt, it licks rock salt. Sea salt is high in sodium, which is unnatural for the body. Instead, it is better to cook with low sodium salt, which is also iodised. Cabbage, cauliflower, brussels sprouts, broccoli, radish, turnip, legumes, pulses, soya and groundnuts contain goitrogens. Goitrogens are substances that hinder the uptake of iodine by the thyroid gland. When there is a deficiency of iodine in the diet, these goitrogens may predispose us to a hypothyroid state. It is therefore always advisable to use iodised salt.

Oil Vegetable oils do not contain cholesterol. In fact, they contain essential fatty acids (EFA) like the monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) that, when present in the right proportion, keep the low density lipoprotein (LDL) or bad cholesterol transporter levels down and help to elevate the high density lipoprotein (HDL) or good cholesterol transporter levels. So, refining oil does not remove cholesterol as is widely believed. The process of refining improves the consistency, colour and smell of oil.

In fact, the chemicals and heat involved in refining oil actually destroy many of the EFA which are so crucial to maintaining the balance between the good and bad cholesterol. Unrefined cold pressed oils should therefore be the oils of choice.

When oil is refined, it is heated for the first time and it is heated again when we use it to cook food. This process converts beneficial essential unsaturated fatty acids into harmful transfatty acids which increase the LDL (bad cholesterol). Indians have the highest rate of heart disease and 25% of heart attacks among men occur below the age of 40 while in other parts of the world the age is 60! Indians have low HDLs which in all probability has resulted from use of refined oils of the wrong quality and eating a high-carbohydrate diet.

It has been conclusively proved that olive oil which has a high percentage (74.5%) of MUFA especially oleic acid, not only lowers total and LDL cholesterol, but also lowers triglyceride levels, increases HDL levels, helps in blood pressure control, has antithrombotic properties (keeps the blood from clotting in the arteries) and helps to improve insulin sensitivity (directs glucose into the cells more efficiently for energy production). So if a teaspoon of extra virgin olive oil is mixed into salad or pomace olive oil ( which smokes at a higher temperature, thus making it suitable for prolonged frying of spices ) is used to prepare food it would certainly be beneficial to health. In addition to the benefits of MUFA in general, olive oil produces LDL that is resistant to peroxidation and is therefore invaluable in the prevention of cardiovascular disease. Since Indians do not like to do all their cooking in olive oil, unrefined oils like mustard oil, sesame oil (gingelly or til), groundnut and rice-bran oils could be used to obtain a good percentage of MUFA. These oils contain from 40–50% of MUFA. PUFA are also beneficial and consist of the omega 3 and omega 6 fatty acids which should be present in the proportion 1:2–5. The omega 3 fatty acids lower triglycerides, prevent inflammatory changes in the arteries, keep the blood from clotting and help to maintain a regular heartbeat. Omega 3 fatty acids are found in fish, egg yolk, dark green leafy vegetables, walnuts, black gram, kidney beans or rajma, wheat, fenugreek, mustard oil (14.5%) and soya oil (6.5%). Since a vegetarian diet contains a low percentage of these omega 3 fatty acids, oils that contain a very high percentage of omega 6 fatty acids (sunflower, safflower and corn oils) should not be used. This will ensure that the optimum ratio between PUFA and MUFA is maintained. Once again, sesame, mustard, groundnut and rice-bran oils provide the right percentage of PUFA (30–50%) and should

therefore be the oils of choice. It is always good to use a combination of oils so that we receive all the fatty acids contained in them. Canola oil may also be used. Mustard oil is also beneficial to the body since it contains oleic acid, which is a MUFA containing Omega 9 fatty acid which is beneficial to health..

Flax or linseeds contain a high percentage of omega 3 fatty acids and may play a significant role in lowering total and LDL cholesterol levels. Wet the seeds with salt water. Dry them in the sun and lightly roast them on a tava till they splutter. They may then be eaten as a snack, sprinkled over salads or mixed into curd and other dishes.

Do not be afraid to use the right quality unrefined vegetable oils as a natural medicine to protect you from cardiovascular disease. As Hippocrates urged, use food as medicine!

TABLE 2.1 Percentage of fatty acids present in various oils OIL PUFA MUFA Groundnut 29.9 49.3 Olive 10 74.5 Sesame 44.5 41.3 Rice bran 35.7 41 Sunflower 66.2 25.1 Safflower 73.5 16.7 Coconut 2 7.8 Palm 10 43.7 Mustard 32.6 56% Butter Soya

2.5 57

28 28

SAFA 20.9 14.8 13.7 22.1 9.1 10.7 89.5 46.3 10.7 69.4 13.1

Source: National Institute of Nutrition; Hyderabad, 2004

Notice how the europeans make it a point to add healthy, unrefined, cold pressed oils to their diet. They have high HDL (good cholesterol) levels and a low incidence of cardiovascular disease. We Indians on the other hand are often advised to go on an “oil free diet� to prevent and treat cardiovascular diseases. Use oil; do not misuse it. Use a maximum of 20 ml per adult per day. This works out to about 600 to 750 ml of oil per adult per month.. Even though coconut oil contains a high percentage of saturated fat (which is why we have been advised

not to consume it) most of this fat is composed of medium chain fatty acids (MCFA) that do not increase our LDL levels and in fact protect us against cardio vascular disease and Alzheimer’s disease. Even though palm oil contains higher levels of saturated fat, it contains equally high levels of MUFA, which is probably why the government of India has allowed its distribution through the public distribution system.

Vanaspati, dalda and margarine are hydrogenated oils and contain trans fatty acids that elevate our LDL and must therefore never be consumed.. Reheating oil many times, as for example, by using the same oil repeatedly for deep frying, also hydrogenates it and this becomes harmful to the body. For this reason it is advisable not to eat deep fried foods that have been prepared outside the home like chips, samosas, potatos, murukkus etc. We do not know which oils have been used and how often the same oil has been reheated. Items that have been deep fried at home in groundnut, seasame, rice-bran or olive oils are not harmful.

Cholesterol Cholesterol is only found in the animal kingdom, there being no cholesterol in the vegetable kingdom. Some cholesterol is required to be included in the diet, since cholesterol is needed for the production of many hormones, Vitamin D, cell membranes and bile. The body produces 75% of its cholesterol requirements and the rest is obtained from the food we eat. Vegetarians, therefore, need to consume one teaspoon of butter or ghee every day. Vegetarians who eat egg may eat a maximum of three egg yolks per week. The whites contain protein and no cholesterol. Non-vegetarians should preferably eat fish including shellfish (both are low in saturated fat) since fish oils contain Omega 3 fatty acids that actually help lower cholesterol levels. The Japanese eat a lot of fish and soya and suffer from a very low incidence of heart disease. Chicken may be eaten without the skin.

Mutton, beef (without visible fat) and organ meats like liver and kidney could be eaten once a week if desired. If you boil your milk in the evening and leave it in the refrigerator overnight, you can remove all the cream the next morning, thus ensuring that you do not receive much saturated fat from the milk that you drink. Use toned milk.

It has not been conclusively proved that a high cholesterol diet leads to increased cholesterol in the blood. There are many nonobese, pure vegetarians who do not consume cream, butter or ghee and yet suffer from hyperlipidemia and coronary artery disease. It is therefore very evident that genetic and hereditary factors, smoking, hypertension, diabetes, stress and sedentary lifestyles play important roles in determining whether one will be affected by high cholesterol levels and atheromatous plaques that block our blood vessels sometimes causing excruciating pain, organ dysfunction and even death.

In fact, it is now known that saturated fat present in the diet maybe a more important factor in raising blood cholesterol levels, than actual cholesterol in the diet. Egg yolk that contains cholesterol but very little saturated fat is therefore safer than butter or ghee that have a higher percentage of saturated fat. Egg yolk contains omega 3 and omega 6 fatty acids in addition to valuable vitamins and protein. In fact, the yolk contains lecithin that actually helps to prevent cholesterol from blocking blood vessels. Lecithin also contributes to a healthy nervous system. However it is inactive at high temperatures and eggs should therefore be eaten either half boiled, scrambled or as omelettes.

Similarly, chicken has very little saturated fat when compared to mutton, beef or pork. Butter, ghee, cream, cheese, visible fat on red meat, organ meats, and coconut and palm oils must be totally avoided by those who have cardiovascular disease.

More importantly, the diet should contain essential fatty acids in the right proportion (more MUFA and omega 3 fatty acids) and other antioxidants like dark green leafy vegetables, herbs, fresh fruit, vegetable oils and nuts, so that the cholesterol present in the blood is not oxidised. This would reduce the incidence of cardiovascular disease.

Coconut Fresh coconut contains invaluable trace elements such as phosphorus, zinc, manganese and copper, folic acid, essential amino acids and fibre. Including a teaspoon of fresh coconut for each person

while preparing food would therefore nutritionally enhance the diet.

Remember coconut oil only forms one component of fresh coconut and this small amount contained in one teaspoon of fresh coconut, will not increase cholesterol levels in the body. Even though coconut oil contains a high percentage of saturated fat (which is why we have been advised not to consume it) most of this fat is composed of medium chain fatty acids (MCFA) that do not increase our LDL levels and in fact protect us against cardio vascular disease.

Calcium Calcium is found in milk and its products like curd and paneer or cottage cheese. Calcium is also found in vegetables like capsicum and green leafy vegetables. Likewise, soya contains calcium. The best source of calcium however is sesame seed (gingelly or til). A hundred grams of sesame seed contains 1450 mg of calcium. South Indians make delicious ‘podis’ (powder) by roasting sesame seeds with a little urad dal, red chilli, asafoetida and salt. This is then powdered and mixed with sesame oil and used like a pickle or a dip for dosas and idlis. However, since the sesame seed contains a high percentage of oxalate, it is unclear how much calcium is actually available for absorption. Alternatively, these seeds may be mixed into a vegetable raita. Very often calcium in the diet is not absorbed into the body because of too much black coffee, non-vegetarian food, soft drinks and alcohol. Once calcium is absorbed it may not get deposited in the bones on account of a sedentary life style, and osteoporosis may result. A brisk half hour walk, stretching exercises for ten minutes every day and two minutes spot jogging, ending with 50 jumps will go a long way towards preventing osteoporosis. Old people and those who have a lower back problem, who cannot spot jog or jump, may sit comfortably on a chair and bang their feet on the ground. This will also help to prevent osteoporosis and will improve blood circulation in the lower limbs, reducing the risk of clot formation in the blood vessels.

(See the section on Exercise below.)

Sunlight

Sunlight is needed to convert cholesterol found under the skin into Vitamin D, which is necessary for calcium absorption. So try to spend at least 15 minutes a day between 9am and 4pm in the sun without using a suntan lotion. Indians usually avoid exposing themselves to the sun. A good idea would be to do your exercises in the sun on an open balcony or terrace or in a garden.

Earth The earth rejuvenates and heals, so kick off your shoes once in a while and walk barefoot on gravel, mud or sand. Early morning dew contains phytochemicals and plant proteins that may be absorbed through the soles of your feet, to benefit your body. So if you do have a grassy patch, walk on it barefoot early in the morning.

Exercise and the Body

A sedentary lifestyle is one of the ten leading causes of death and disability. You must exercise to keep fit. Ten minutes a day of stretching and toning excercises ending with 5 minutes spot jogging, 50 jumps (not for those with a back problem) and a brisk 20 minutes walk is sufficient to keep the body supple and healthy. Take long strides and swing your arms when you walk. If necessary, use music to liven up your exercise workout and break out into a dance as you spot jog. You must involve yourself positively as you exercise; you must enjoy exercising. Another good idea would be to run up and down 40 steps at least four times twice, a day ( not if you have a knee or back problem ).

It is not advisable to exercise with the intention of losing weight or maintaining your weight loss. Your ideal weight will be achieved and maintained by putting the right food into your mouth. Remember, there is no such thing as spot reduction, so don’t get carried away by

misleading advertisements that promise spot reduction. When you lose fat you will automatically lose inches from all parts of your body.

If you want to see your weight going down don’t do any muscle building exercises or exercises with heavy weights. Muscle is heavier than fat and although you will lose in inches you won’t lose much weight. If you enjoy going for aerobics, go on alternate days, for the same reason.

If you can spot jog for 15 minutes it will help to maintain your metabolic rate. If you cannot spot jog for 15 minutes at a stretch, jog for two minutes and walk for four minutes (around the room, if necessary). Repeat this process four times. A healthy metabolism will ensure that your body responds positively to your diet, and if you regain weight in the future, going back to choosing the right quality food will once again result in weight loss.

Do your exercises regularly every day before your bath. It should become a part of your daily routine like brushing your teeth. Don’t say, “I don’t have time!” Everyone can find 15 minutes in 24 hours to keep the body fit and flexible. Spot jogging is important to increase your

cardiopulmonary capacity and to build up the collateral circulation in your heart to protect you against the ill effects of blocks in the coronary blood vessels as you grow older.

I have personally experienced the benefits of a 30 minute brisk walk if possible, twice a day . Such a walk rejuvenates the body and keeps you alert and active throughout the day. The human body has been fashioned so that we might use our legs. Today, most of us sit in chairs for almost twelve hours and lie down for eight hours. This leaves us with just four hours on our feet. If one of those four hours can be used to really move our feet as they were meant to be moved, many of the present day ailments could be prevented.

Studies have shown that moderate exercise, as explained above, helps to lower blood pressure, since the blood vessels dilate when the heart pumps blood more quickly. Exercise also raises the HDL (good) cholesterol and helps to increase plasma serum, thereby keeping the blood thin. This decreases the chances of blood clots being formed in the arteries. All these factors contribute to a lower incidence of coronary artery disease. Exercise also helps to regulate menstrual cycles in those women who have polycystic ovarian disease and other hormonal imbalances; it helps to overcome insulin resistance that occurs in people with diabetes and obesity; it reduces stress and anxiety and helps to alleviate depression. The immune system and lymphatic drainage are enhanced by exercise, resulting in greater resistance to disease, malignancy and aging.

Pranayama (Deep Breathing) and Yoga Yoga is excellent for both your body and mind. You can follow a wellwritten book on yoga or learn it from a master. Do fifteen minutes of deep breathing every day.

Breathe in fully through both nostrils with the mouth closed. Breathe out slowly through the mouth ending with a forceful expiration by contracting the abdominal muscles. This will completely clear the lungs of sputum and secretions. Also the lymphatic drainage will be improved, thus facilitating the removal of extra fluids from the body.

Sit upright and place one hand over your abdomen. Now contract and relax your abdominal muscles, so that you can see your hand move in and out. Next, with your mouth closed, breathe out through your nose each time your abdominal muscles and hand go in. Do this 20 times continuously at least three times a day. Do this simple exercise in any position, sitting, standing or even lying down. In addition to strengthening your abdominal muscles, it will also facilitate lymphatic drainage and augment your metabolism.

Mudra Pranayama It is believed that by maintaining certain hand positions (mudras) during deep breathing exercises (pranayama), we can direct our breath more effectively and specifically into the five lobes of our lungs.

Prana (life energy) is then directed through various channels to energise and heal the body. I have personally experienced the benefits of mudra pranayama and would advise you to read Raja Yoga Pranaya” by G. Gautama.1 Sit down on a stool and massage the soles of your feet. Acupressure teaches us that every part of the body is represented by a point on the soles of our feet. So massaging these points will have beneficial effects on all parts of the body Acupressure Acupressure is believed to have originated in India about 3000 years ago. The basis of acupressure is the belief that bioelectricity passes through the whole body beginning at the tips of the fingers and ending at the tips of the toes. Each part of the body is thus represented at a particular point on both of our hands and feet. A dysfunctioning part of the body may therefore be activated by applying pressure or massaging that point in a clockwise direction. This takes just a few minutes to do and can be done at any time and in any place. We spend so much time cleaning and decorating our bodies externally, it would be prudent to familiarise ourselves with this ancient art of healing so that we might be able to heal and energise ourselves internally. I have personally experienced the benefits of acupressure

1

G. Gautama, Raja Yoga Pranayama. Published by G. Gautama, P. O. Box 8728, Chennai 600020. The author and publisher may be contacted at <gautama@mail.com>.

and recommend that you read Health in your Hands by Devendra Vora.2 Posture Always stand straight with your weight equally balanced on both feet.

See that your feet do not turn inwards when you stand; this wrong positioning of the feet will not help those who have a tendency towards flat feet. Your weight should fall more on the outer sides of the soles of your feet. Always tuck your stomach in and brace your shoulders back and down, keeping your spine straight. Bend your head forward to touch your chest as often as you remember and also arch it backwards and turn it from side to side. These simple exercises will go a long way towards preventing cervical spondylosis which leads to compression of the nerves and results in pain over the neck, shoulders and arms.

Care for the Body Skin and Hair Care Pour water over yourself and rub your body vigorously all over. This will enhance blood circulation under the skin and keep your skin glowing. Since soaps contain chemicals they are likely to be absorbed through the skin, which is the largest organ of the body. Contrary to popular belief, it is not necessary to use soap while bathing. Try using just water and see how soft and smooth your skin feels! You will also see an improvement if you have cracked feet. Soap may be used when there is visible dirt, oil or extreme body odour.

Rub a teaspoon of olive or mustard oil all over your body while it is still wet. The water will help to spread the oil and it will keep your skin soft and nourished. Then pat your body dry with a towel.

Air pollution makes the hair greasy and dirty. So tie a scarf over your hair every time you leave home and take it off once you have

2

Devendra Vora, Health in Your Hands. Gala Publishers.

reached your destination. Do not wash your hair more than twice a week.

If you have long hair, tie it up or plait it if possible before you go to bed. This will prevent your hair from getting pulled and tangled while you sleep and you will lose less hair when you comb it out in the morning.

When you begin to lose some fat from your face, you might find that your hair is falling. No one complains of hair loss until they lose fat from the face and therefore also from under the scalp. It is not a nutritional problem but a mechanical one. The hair is held tightly in the hair follicle by the surrounding cells, which include fat cells. When fat cells become empty, the follicle widens, the hair becomes loose and it falls out. After a while the surrounding cells will reorganise themselves, so that the follicle is restructured and the new hair growing from it will not fall out. So donâ&#x20AC;&#x2122;t panic when you lose hair, it is a temporary phenomenon.

Teeth Gargle well and brush your teeth after every meal. Also floss your teeth for at least two minutes after every meal to remove food particles from between your teeth. Food particles and bacteria form deposits called plaque, which if not removed result in cavities in your teeth. Visit a dentist every six months to have your teeth scaled and cavities filled in time so that you donâ&#x20AC;&#x2122;t eventually lose a tooth! Massage your gums once a day with your fingers. This will augment blood circulation in the gums and make them healthier. Donâ&#x20AC;&#x2122;t brush hard or for too long. If you have flossed well, a light quick brushing is all that is required.

Nostrils Dip your index finger into a little vaseline and smear it over the nasal mucosa inside each nostril. Do this both in the morning and at night.

The vaseline will prevent allergens and microbes from exerting their harmful effects and will help to prevent nasal allergies and infections.

Sleep It has been shown that lack of sleep doubles the rate of heart attacks.

People who sleep less also tend to be more obese. Try to get at least eight hours of sleep every day. If possible, take a nap in the afternoon especially if you have woken up early and been busy and stressed all day. Today, stress is responsible for many unhealthy physical and mental conditions. As most people work late into the night, a nap in the afternoon rests the body and mind so that one wakes up refreshed and capable of facing the rest of the day. Sleep in the afternoon also has a beneficial effect on dark circles under the eyes. There is a misconception that sleeping after a meal nap results in weight gain.

Again, learn from nature. Does any animal get up and run around after a heavy meal? Weight gain results from wrong eating habits and has nothing to do with an afternoon nap. When the body rests cortisol levels decrease and glucose is more efficiently directed into the cells to be stored as energy. Our serum cortisol levels are lowest between 10pm and 1am. This is the time when the body is most sensitive to insulin and when energy is most efficiently produced and then stored in mitochondria so that one may wake up fresh and energetic in the morning. This is why you have been advised to eat high carbohydrate foods at the night meal.

Sex Having sex with ones marital partner is one of the most natural and stimulating of activities. Sex stimulates the secretion of the growth hormone and keeps you looking and feeling younger. In todayâ&#x20AC;&#x2122;s world it can be a most important factor that keeps a marriage together.

3

Composition of This Diet Table 3.1: Composition of this diet

Carbohydrate In this diet, 50% of the calories come from carbohydrates, making it a carbohydrate-restricted diet. This diet is not to be confused with the low carbohydrate diets which are popular in Western countries where only 25% â&#x20AC;&#x201C; 35% of calories come from carbohydrates and the carbohydrate content is below 40 g per day. All foods contain some carbohydrate in them, except non-vegetarian food, egg and both animal and vegetable oils. In this diet we eat plenty of those foods that are low on carbohydrates and restrict quantities of foods that are high in carbohydrate.. We eat till we are satisfied. This diet emphasizes not on how much you eat, but what you eat and when you eat it. We do not have to count calories and this is what makes the diet so enjoyable. The greatest advantage that this diet has over other diets is that hunger disappears. It is because our own insulin levels are never high during the day. On your present diet that includes high carbohydrate foods like rice and wheat in large quantities at every meal, insulin levels are always high. High insulin levels cause you to become hypoglycemic about two hours after a meal and hypoglycemia (low sugar) makes you hungry. This is why you always seem to be

hungry on a high carbohydrate diet. Ask anyone who has been on this diet and they will tell you that they are not hungry and they do not crave for food. This is another reason why this diet is so popular. The more strict you are, the more comfortable you feel, and this motivates you to be even more strict with yourself.

As mentioned above, this is a carbohydrate-restricted diet. Just because you are avoiding rice and wheat during the day does not mean that you are avoiding carbohydrates. Never forget (and I repeat this for emphasis): all foods contain some carbohydrate in them except for oil, egg and non-vegetarian food.

Eggs, paneer, soya channa, soya nuggets, tofu or non-vegetarian foods that contain negligible amounts of carbohydrate may be added to the meal at lunch or dinner.

Put simply, when extra glucose is absorbed into the blood and it cannot be utilised, it is stored as fat. Think of your fat as stored glucose. If you want to lose it, some of the stored glucose must provide energy for your body. This will not happen as long as your diet has enough glucose in it to supply your energy needs. It is only if your dietary glucose cannot supply all your energy requirements that some of your stored glucose will get used. It is like buying provisions for the home every month. After the kitchen containers are full, the extra provisions are put into the storeroom. The stored provisions are used only when those in the kitchen are finished. With provisions in the kitchen, the storeroom remains out of bounds.

In todayâ&#x20AC;&#x2122;s urban setting, those who tend to become overweight need about 60% of their food by weight to come from carbohydrate.

Since the traditional Indian diet contains over 80% carbohydrate by weight, the extra 20% is converted into fat, which results in obesity.

This 50% carbohydrate diet provides the body with five-sixths of its energy requirements while it draws one-sixth of its energy requirement from fat deposits. This 50% carbohydrate diet which contains 145 g of carbohydrate, also seems to be the optimum amount of carbohydrate that most diabetic patients in the early stages of the disease can deal with, since insulin secretion is either deficient or the body has become unresponsive to insulin ( also known as insulin resistance ). Therefore giving any more carbohydrate naturally causes elevated blood glucose levels. Some people however, need only 40â&#x20AC;&#x201C;50% of their calories to come from carbohydrate and will find, that unless they eat only side dishes without seeds for lunch ( not even pulses ), thereby reducing their carbohydrate intake to about 100 g per day, they will not lose weight or effectively improve their blood glucose levels. They may however eat seeds at dinner time, since the body is sensitive to insulin at night between 10pm and 1am when our serum cortisol levels are low ani It is at this time that glucose is more efficiently directed into cells to be stored as energy.

Protein This diet provides you with 20% protein. The diet ensures that you are able to get adequate protein in your diet and this must be calculated depending upon your body weight. You need one gram of protein per kilogram body weight per day. Children however require higher quantities of protein as shown below.

The table given below provides approximate quantities of protein required by children in different age groups. Protein needs to be increased when children have an infection or fever.

TABLE 3.2 Protein Requirements of Children Group (years)

Protein (g/day)

Children 1–3 Children 4–6 Children 7–9 Boys 10–12 Girls 10–12 Boys 13–15 Girls 13–15 Boys 16–18 Girls 16–18

22 30 41 54 57 70 65 78 63

Source: Recommended Dietary Allowances for Indians. Nutrition for Mother and Child, National Institute of Nutrition, ICMR, Hyderabad. Fifth Edition, 2002.

Adults Adults may obtain their daily protein requirement from the following foods: Cereals and pulses 20 g 100 g greens 5g 500 ml milk 20 g 75 g non-veg food or 25 g soya with 50 g paneer 15 g

Total 60 g for an average Indian weighing 60 kg Listed below are the protein g weight or 100 ml volume: soya cheese chicken and meat fish and pulses prawns Oats paneer two egg whites wheat rice and ragi milk

contents of some common foods, per 100 40 g 30 g 25 g 20 g 19 g 13.6 g 13.5 g 13 g 12 g 7g 5g

Below are 10 g protein portions a. b. c. d. e. f. g. h. i. j.

250 ml milk or curd 100 g greens or mushroom and 200 g other vegetables 25 g pulses and 125 ml curd 50 g paneer and 13 almonds 25 g soya 25 g rice or 30 g wheat with 25 g pulses and 100 g vegetables 1½ egg whites 85 g fish with bones 75 g chicken with bones 50 g prawns

Try to include 20 g of protein at each of your two meals. You will automatically receive another 20 g by consuming 500 ml of milk every day by using it for making tea, coffee and curd. This will provide 60 g of protein for an average person who weighs 60 kg.

Oil This diet contains 30% oil. Twenty grams from the invisible oil present within the foods we eat and 20 g comes from vegetable oils, required for the preparation of tasty food. Use a combination of unrefined sesame, rice-bran, olive, mustard, groundnut and olive oils to derive

maximum benefit from the essential fatty acids that these oils contain.

Remember these fatty acids are not manufactured in the body and they must therefore be obtained from oil in the diet. Vegetable oils contain Vitamin E, a natural antioxidant that protects us against heart disease. Confining yourself to one type of vegetable oil all your life is not natural. It is more natural to use a combination of oils. Some like to mix all the oils together and others prefer to use different oils for different food preparations.

Tips on how to cut down on oil 1. At every meal try to eat only two items that have been prepared with oil.

2. Steam vegetables before you temper them.

3. Add a little salt to oil before frying onions. They will brown faster.

4. Always cook in thick iron or steel utensils. Heat the pan, add about 30 ml oil, swirl it around the pan to coat it well and then pour it out.

You can easily stir fry meat or vegetables in this amount of oil and even masalas can be fried completely this way.

5. Since soya contains 20% oil always try to make oil free items like chapatis, noodles or idlis when mixing it into cereals and pulses in preference to other oily preparations.

6. Always eat non-oily soya preparations with egg, paneer and nonvegetarian foods, because these foods contain oil anyway.

7. Always eat egg, paneer and non-vegetarian food with salads and fruit that contain no oil.

8. Always boil chicken and other meats first. Refrigerate the stock, for about eight hours. Skin off the top layer and use what is underneath to prepare the gravy. This way we remove saturated fat which these foods contain.

9. Depending upon how many adults are present in a household calculate a maximum of 800ml of oil for each adult per month.

Children over eight must be counted as adults. Buy all your oil at the beginning of the month. Measure out a fixed quantity of oil every day and do not use any more than this. Use a maximum of 25 ml of oil per person per day. For example, for 2 adults, use a maximum of 50 ml oil per day.

10. Depending upon how many people will eat a certain preparation use one teaspoon of oil for each person. For example, if two

people are to eat a certain preparation use only two teaspoons of oil while preparing that dish.

Vegetables Raw vegetables Depending upon the quantity of rice you eat every day for lunch, eat instead, an equal quantity of raw vegetables cut into small pieces.

This will fill you instead of rice. You may eat plenty of cucumber, cabbage (the inner tender leaves), capsicum , chow-chow (squash), tomatoes, radish, onion, turnip , lettuce, celery, broccoli, brussels sprouts and plenty of coriander leaves.You may add a little carrot and beetroot for colour.

Raw vegetables may be eaten with salt, pepper, lime juice, cumin etc or even with a teaspoon of mayonnaise or thousand island dressing occasionally. More commonly, raw vegetables are relished when they are mixed into one cup of curd to prepare a tasty raita.

Alternatively, they may be grated, lightly steamed, mixed into curd and tempered, making this a good substitute for curd rice.

Cooked vegetables Buy plenty of vegetables. Remember they are our natural food. Cook them so that they taste very good by using oil and a variety of spices, herbs, tamarind etc.

You may eat plenty of greens, brinjal, ladies fingers, cabbage, cauliflower, drumstick, capsicum, radish, turnip, all the fresh beans and all the watery vegetables such as the gourds. Mushrooms may also be eaten.

Avoid eating large quantities of all varieties of potato, sweet potato, tapioca, unripe banana, yellow pumpkin and peas, along with other vegetables, since they contain a higher percentage of carbohydrate. If you want to eat these vegetables make sure you have only 100 g of

any one of them together with those foods that contain a greater percentage of protein.

Milk Products Curd You may have 250 ml of curd every day. Curd is healthier than milk, since the undigestible lactose has been converted in it to lactic acid.

Curd also helps to augment the growth of protective bacteria in the large intestine.

Paneer or Cottage Cheese You may eat 50 - 75 g of home-made paneer per day ( approximate amount that is obtained from half a litre of low fat milk ). Paneer bought from a shop, which is made from whole milk, will contain more saturated fat, because it will contain cream. Therefore, restrict yourself to only 50 g of it per day. Paneer made at home from low-fat milk contains less saturated fat.

Beans and Pulses Soya Bean

The Soya Bean comes in many colours, but the most commonly available in India, is pale yellow in colour (not creamy white) and it has a short brown line running down one side. Soya with its low carbohydrate content of just 20% (although many Indian varieties contain upto 33%), low glycemic index of 18 and high quality protein

(which has a direct effect of lowering elevated trigyceride and bad cholesterol (LDL levels), is invaluable, if included in the diets of those who are obese or diabetic. It reduces the carbohydrate content of cereal and pulses when mixed into them, thus enabling us to eat all our favourite traditional foods and still lose weight, control elevated blood glucose levels and improve our lipid profiles. By mixing soya flour into items made from maida and rice ( which are Indiaâ&#x20AC;&#x2122;s number one junk foods ), like chapattis, idlis and dosas and by cooking soya flakes with rice, we may effectively convert junk foods into health foods for the whole family. Soak the soya bean for two hours before pressure cooking it to prepare a channa/sundal. It requires slow cooking on a low flame for about fifteen minutes after the first whistle.

It does not cook if you give it four to five whistles.

Always eat preparation made from roasted soya, to inactivate a trypsin inhibitor which is present not only in soya but also in other foods, which is why corn, nuts and pulses are usually roasted before we consume them. East Asian countries have been consuming fermented soya products for centuries and appear to be healthier because of it.

Always soak and ferment the soya bean along with cereals and pulses when preparing idli, dosa or appam. All cereals pulses, corn, oats and soya contain phytates that may bind with certain minerals in our diet thus decreasing their absorption. Fermentation decreases the amount of phytates, which is probably why many South Indian preparations made from rice and pulses, like idly dosa and appams are fermented before they are prepared. Wheat is also fermented in countries that eat bread and pizza by adding yeast to wheat flour and in North India naan is also prepared from dough that has been fermented with yeast.

When preparing chapatis soya and wheat flour, make the dough using buttermilk instead of water or a little activated yeast can be mixed into the dough. Cover the dough with a muslin cloth and let it stand for about three hours before preparing chapattis.

About 25 g of soya may be consumed every day. It may be mixed into cereals and pulses to make traditional Indian dishes and may be eaten at dinner time. Unfermented soya preparations should be consumed only occasionally. This small amount of soya will also provide 10 g of high quality protein which is invaluable for those who are vegetarians.

Soya nuggets, flakes and granules are readily available in the market and may be included for lunch in this diet.

Soya protein isolate, which is the main ingredient of protein supplements recommended for weight reduction, is not produced in India from home-grown soya. It is imported and we may not be sure about the quality of soya used. I therefore do not recommend using these supplements because they may be made from genetically modified soya bean.

Goitrogens are substances that hinder the uptake of iodine by the thyroid gland. When there is a deficiency of iodine in the diet these substances like cabbage, cauliflower, brussel sprouts, broccoli, radish, turnip, pulses, groundnuts and soya may predispose us to a hypothyroid state. This may be prevented by using iodized salt for cooking. Those who already suffer from a hypothyroid state should consume all the above mentioned items only occasionally.

Pulses All pulses contain 60% carbohydrate in them. Contrary to popular belief, the small yellow moong dal does not contain less carbohydrate.

It is however better digested, which is why it is frequently given to young children, old people and those who have digestive problems.

Pulses may be cooked with extra water, to reduce the carbohydrate content of the diet.. Restrict yourselves to just 25 g of pulses at lunch time and 50 g at dinner time. Since pulses are predominantly high carbohydrate foods, combine them with low carbohydrate and predominantly protein foods, as will be explained later.

Sprouted Pulses Sprout pulses at home by soaking them in water overnight and then tying them in a thin cloth, which must be kept constantly wet. Sprouted pulses contain more water and less carbohydrate in them and may therefore be eaten as a soondal or channa (whole) or ground in a mixer and then made into a dosa. Sprouting also enhances the nutritional value of pulses by activating certain enzymes and

increasing the Vitamin B and C content. Phytates, which are widely distributed in seeds, bind iron. Sprouting reduces the phytate content in seeds and increases the proportion of unbound iron. This iron, in the presence of Vitamin C, is then readily absorbed into the blood.

Oats Oats contain 63% carbohydrate, so restrict yourself to 50 g or three dessertspoons of it and eat it at dinner time. Cook the oats in water; temper with a little mustard and red chillies; add a little buttermilk and salt. You can also cook one dessertspoon of oats and have it with diluted milk, a little cardamom and sugar. Or you may mix cooked oats with a tasty seasoned vegetable, sprinkle some salad over it, add a little rasam to it and enjoy your meal. Oats contain soluble fibre that slows down carbohydrate absorption. It also contains Gamma Linolenic Acid (GLA) which is an essential fatty acid that helps to relieve premenstrual syndromes, reduce elevated blood cholesterol levels and may help in atopic eczemas. Oat bran is rich in fibre and may be mixed into wheat and soya flours to prepare chapatis.

Fish, Shellfish, Chicken and Egg Non-vegetarian foods and egg contain predominantly oil and protein with negligible amounts of carbohydrate. They may therefore be ideally combined with foods which contain predominantly carbohydrate at either lunch or dinner Fish and chicken (without the fat and skin) and shellfish are the safe non-vegetarian foods since they contain minimal amounts of saturated fat. Non-vegetarians should try to eat fish at least twice a week. Fish oils contain omega 3 fatty acids that decrease triglycerides, prevent inflammatory changes, prevent blood from clotting within the blood vessels and help maintain a regular heartbeat. All these effects help to protect us from cardiovascular disease. You may prepare nonvegetarian food anyway you likeâ&#x20AC;&#x201D;even fry it. Visible fat on mutton and beef should be removed before cooking and these foods along with organ meats should be eaten only occasionally since they contain high levels of saturated fat. Restrict yourself to 150 g fish, 75 g prawns or

175 g chicken (which includes the bones) and eat non-vegetarian food at only one meal a day or on alternate days.

Do not be afraid to eat egg yolks. Even those who have high cholesterol levels may eat three egg yolks a week. One egg yolk contains the exact dietary cholesterol requirement for one day. If this is not provided in the diet, cholesterol will be manufactured by the liver. The yolk contains invaluable vitamins, iron, Omega 3 fatty acids and even some protein. It contains very little saturated fat and contains lecithin that actually prevents bad cholesterol from depositing in blood vessels.

Liquids Two cups of either tea or coffee one in the morning and one in the evening using milk and water in equal quantities and a total of four teaspoons of sugar for both. If you do not drink tea or coffee, then any malt drink with a little milk may be included..Or you may have a glass of coconut water, sweet lassi or lime juice with sugar or honey instead.

These are the non sugary liquids that may consumed during the day, in between meals 250 ml curd may be made into buttermilk or a curd kadhi.

Rasam or dal soup.

Tomato juice made from 2 tomatoes and a little lime. .

Lime juice from half a lime. Add salt (or jal jeera powder) Soda.

Soups made from greens, tomatoes, cabbage, cauliflower, gourds, onions, mushroom and chicken. .

Do not drink fruit juices, juices sold in tetrapaks or soft drinks between meals. You may however drink any of these at mealtime, combined with foods that contain predominantly protein, as will be explained later.

Pickles and Chutneys

Include pickles and chutneys in your diet in small quantities since they might enhance the flavour of your food and make your food more enjoyable to eat. We are using low sodium salt for all cooking and table use, so a little extra salt from pickles will not harm you.

Snacks Roasted soya nuts may be prepared by roasting the softer yellow variety of soya with salt and chilli powder. One fistful of soya snacks or any other channa, either mid-morning or at tea time, will not harm you.

A few almonds, pistachios or walnuts, a small cup of popcorn, two pieces of fruit, one roasted papad, three salt biscuits, a fistful of groundnuts or a small masala vada, could be alternate snacks.

High-Carbohydrate Foods Cereals, millets and pulses: Always measure seeds in fistfuls instead of

cupfuls. Seeds are unnatural foods and must therefore be eaten in measured quantities. Big built individuals have bigger fistfuls than smaller built individuals; their bodies need those extra seeds!

You may eat two fistfuls of seeds (50 g) preferably either pulses or soya, at lunchtime and two fistfuls of seeds (50 g), either rice or wheat or pulses at dinner time . A fistful of roasted soya mid-morning and a fistful of groundnuts at teatime could also be included: a total of 150 g of seed or nuts in a day.

When 50 g of rice is cooked, separate the grains so that they do not stick to one another, as in a pulao, and measure out 16 teaspoons. If the grains are closely packed as in curd rice, then measure out 8 teaspoons. This small quantity contains 10 teaspoons of glucose, so understand why you must be careful about how much rice you eat.

When you measure out these limited quantities, imagine that you are measuring out honey!

After dinner we are asleep and no food will enter our body for the next eight hours. The glucose absorbed into our blood from these high-carbohydrate foods readily enter the cells to form and be stored as energy because the body is most sensitive to insulin between 10 pm and 1am.This is because our own steroid levels are low at this time. Digestion uses up a lot of energy, so the best time to eat a heavy meal is at night. The body can then divert its energy to the digestive process, which will be effectively completed while we are asleep without unnecessarily tiring us. Another reason for eating larger quantities of high carbohydrate foods only at night, is that the hunger response that appears 2 to 3 hours after we eat high-carbohydrate foods will not affect us when we are asleep.

In this diet, hunger gradually disappears and one is therefore very comfortable eating restricted quantities of high carbohydrate foods at night. Also, most people are busy during the day and do not have time to really mind what they eat. But in the evening when family and friends get together and socialise they would not like restrictions in the diet and would like to choose from a variety of high-carbohydrate foods. It is for all these very valid reasons that I have chosen to allow larger quantities of high-carbohydrate foods at night instead of in the afternoon.

Choose any one of the following items as the main dish for dinner and eat them with the usual side dishes: 1. Rice items : 3 to 4 idlis /dosas/ idiappams made from 3 to 4 scoops of batter/ Pongal or kitchdi made from one fist of rice and one first of dhal/ rice that is prepared from 2 fistfuls of uncooked rice/ 2 fistfuls of beaten rice/ one 150 ml cup of

puffed rice to be made into bhelpuri. . At a South Indian hotel : one plain dosa/ 2 big idlis/ one heling ghee pongal etc 2. Whole wheat items: 3 to 4 small chapattis / 3 puris / 2 parathas / 3 to 4 slices of whole wheat bread / 50 g whole wheat noodles, macaroni or pasta / 2 to 3 slices of whole wheat pizza / one 6 inch whole wheat sub / 2 fistfuls whole wheat rava for dallia or uppuma / 3 whole wheat dosas 3. Dhal items: 50 g channa/ 2 to 3 chillas ( dhal dosas ) / 3 to 4 vadas / 250 g khamman dhokla 4. Roasted or cooked corn / 150 g potato/ 100g yam / raw banana 200 g 5. 50 g oats A good idea would be to alternate between the above varieties of food.

Each type of food has its own unique combination of vitamins, minerals and amminoacids. So the greater the variety the healthier we would be.

If you find that you are not losing weight, then eat items made from pure wheat and rice only once in three to four days. Mix soya flour ( which has only 20 to 30% carbohydrate depending upon the variety ) with wheat flour and wheat bran in the proportion 1:1 :1 to make chapatis or dosas in the days between, or ferment 25 g soya flour with two scoops of the normal idli /dosa batter before preparing idlis or dosas. This will further reduce the carbohydrate intake in the diet which would facilitate weight reduction.

4

The Complete Health Plan Six Fistfuls of Seed / Nuts—150 g per day Breakfast Most importantly, and I wish to emphasise this repeatedly, that it is not natural to eat a high carbohydrate breakfast, especially for those who want to lose weight. There is a popular Western belief that breakfast should be eaten like a king, lunch like a prince and dinner like a pauper! Consequently, there are many who are puzzled when I tell them that to be in tune with nature and the natural rhythm of our hormones, we should not eat a heavy high carbohydrate meal in the morning. These well meaning people are using common sense ( one does not need education to come to this conclusion ); they feel that since we need to use energy during the day we need to eat breakfast like a king. Unfortunately our body does not work according to common sense ! The body does not produce energy on demand. It is not told when each of us will be requiring more energy. Suppose you plan to start for a journey in your vehicle early in the morning, would it not be prudent to fill it with petrol the night before ? Well this is exactly how the body works too.

Our own cortisol levels are highest in the morning between 6 and 8 am. This is when the body is “insulin resistant” which means that insulin receptors are least sensitive to insulin and glucose is therefore more readily converted into fat. This also explains why those who are under great stress, or who have been on steroid medication tend to put on weight. Our cortisol levels are lowest between 10 pm and 1 am in the morning, resulting in a state of insulin sensitivity. This is the time when glucose readily and most efficiently enters the cells to be stored as energy. This is why high carbohydrate foods like cereals, pulses, millets, fruits, most root vegetables and sweet dishes should be included in the night meal. The body has been primed to convert glucose into energy most efficiently at night. This energy is stored in mitochondria which are present in every cell of the body. Remember learning about the “power houses of the cell” in school? Energy is thus

readily available for us to wake up in the morning and we are active even without eating breakfast like a king!

Eating a high carbohydrate meal in the morning is like filling petrol into your vehicle in the morning even though you have filled up the night before. We wake up in the morning full of energy (from the carbohydrate eaten the night before) and do not need to fill up again on complex high carbohydrate foods even before we have started the day! In addition, we do not need to waste this energy on digesting complex high carbohydrate foods (like rice, wheat and pulses). Simple carbohydrates in the form of fruits, raw vegetables, milk or cane sugar along with predominantly protein foods are ideally suited to this time of the day.

Early humans went out in the morning in search of food; there would then have been no question of their eating like kings. Consequently, the body conserves glucose in the morning. By the time early humans had found enough food and cooked it, it would have been evening, and this is when the body utilises glucose best. Traditionally Indians did not eat breakfast. A New Way to Eat leads us back to our traditional eating patterns which were scientific and in tune with nature.

Start the day with a nice cup of tea or coffee ( half milk and half water ) and one and a half teaspoons of sugar. If you do not drink tea or coffee you may drink either one glass of coconut water, lassi, an almond milk shake (using 5 almonds, diluted milk and one teaspoon of sugar) or lime juice with two teaspoons of honey or suagr. Or you may have a malted drink made with diluted milk and no sugar.

If possible, go out for a brisk 20-minute walk. It will rejuvenate you and make you alert and active throughout the day.

At about 9 a.m. or two hours later, choose 200 g of either tomato, cucumber, guava, a small sweet lime, one kiwi, one peach, half an avocado, 150 g berries ,8 pieces of either papaya or melon or two slices of pineapple. Eat any one of these with either a fistful of roasted soya nuts, 6 almonds, 8 pistachios or 2 to 3 walnuts (your first fistful of seeds/nuts).

At about 11 a.m. or two hours later, you may drink either a glass of dilute buttermilk, cold rasam (without pulses) or lime juice with salt or jal jeera powder.

Lunch Place a large heap of raw vegetables, either grated or cut into small pieces in the centre of your plate (to replace rice) and mix it with 125 ml home-made curd which may be seasoned and prepared from toned milk, Place a generous helping of tastily prepared cooked vegetables/mushrooms (excluding potatoes, yam, tapioca, raw banana and corn) beside it. Now choose any one predominantly protein food such as chicken (without the skin and fat), fish, egg, 50 g paneer / tofu or 25 g of soya nuggets / flakes/soya channa (your second fistful of seed). About 25 g of another channa (your third fistful of seed) may also be included at lunch time for those of you who do not need to lose weight. Remember, pulses are not predominantly protein foods. Alternatively, you may eat each item separately or all mixed together, out of a bowl with a spoon. Remember to chew well and eat slowly. Relish and enjoy your meal that is tasty and healthy.

Eat for at least 20 minutes so that you feel that you have eaten well.

Your plate is full of tasty, nutritious food, loaded with vitamins, minerals, antioxidants, good quality protein and just the right amount of carbohydrate. Eat slowly, relishing every mouthful, so that you are completely satisfied. Eat for at least 20 minutes.

After about a month of following this pattern, by which time your appetite would have decreased and you will be very comfortable on this diet plan, you may replace all the vegetables with either 50 g of any channa ( pulse ) preparation or 200 g of a fibrous fruit and combine it with any one protein item. This will bring variety into your diet. Maybe twice a week channa; twice a week a fibrous fruit and vegetables three times a week.

Do not include any items made from rice or wheat in your diet at lunch time if you want to lose weight

Office Lunches One big container should be filled with raw vegetables, which have been cut into small pieces and another small container with seasoned curd. Mix the two just before eating to make a fresh tasty raita. When you begin this diet, the raita is a must, since it is filling and will force you to chew well and eat slowly . . Fill another container with cooked vegetables and choose any one predominantly protein food as explained above . Another idea is to mix the curd and raw vegetables into the cooked vegetable. You have a large bowl of tasty, healthy crunchy food which will take you at least 15 minutes to eat. Eat the protein item either along with it or separately.

Those not working may, if they wish to, sleep after lunch with a clear conscience. No weight gain will result on account of this nap.

Remember, our cortisol levels are lowest when we are calm and relaxed in the lying down position. When cortisol levels are low, glucose enters the cells more efficiently to be stored as energy instead of as fat.

Evening At about 4.30 pm or three hours after lunch you may have a drink with one and a half teaspoons of sugar in it. You may choose between coffee or tea, lime juice , dilute lassi or a glass of coconut water. You may also munch on 3 salted biscuits or a fistful of roasted channa ( pulse ) or groundnuts (your fourth fistful of seeds / nuts).

If you have not been able to walk in the morning, go out for a brisk 20-minute walk in the evening. This is not to lose weight, but to keep fit.

Dinner Eat your dinner as soon as you feel hungry. Choose any one of the items mentioned below ( which are made out of rice, wheat, oats, pulses, corn, other millets ( your fifth and sixth fistfuls of seed ) or root vegetables like potatoes or items with sugar such as ice cream, milk shakes and desserts in the specified quantities ) and eat them with

regular side dishes which may include, a big mug full of soup, dhal ( watery pulse ), rasam, lime juice or curd kadhi, vegetables, mushrooms, paneer, sprouts, egg, or non-vegetarian This way you will not miss eating any of your favorite foods; you just have to wait for the right time to eat them. The quantities mentioned in grams refer to raw ingredients.Side dishes do not include solid pulse preparations ( like channas, adais ,vadas and khamman dhoklas ) , corn or potatoes/raw banana. When these are eaten they constitute the main dish because they are high in carbohydrate.

Items prepared from rice: 1. 3 -4 scoops of batter to prepare 3 -4 idlis/ dosas 2. 25 g rice and 25 g dal to prepare pongal or khichdee 3. One cup puffed rice to be made into bhel puri 4. Half cup beaten rice 5. 50 g rice 6. 3 small idiappams Items prepared from whole wheat/millets/oats 1.

2.

3.

4.

5.

6.

7.

8.

9.

3-4 small phulkas / 2 puris / parathas 3-4 slices whole wheat/ multigrain bread 6â&#x20AC;? whole wheat sub 2-3 slices whole wheat pizza 50g whole wheat / multigrain noodles / pasta 50g whole wheat rava / dalia 3 scoops batter to prepare whole wheat/ ragi dosa 2-3 Bajra / jowa / corn rotis Eat the corn off a large cob of corn / 75g sweet corn/ corn soup/ 2 cups popcorn 10.

30 g oats Items prepared from pulses 1. 50 g channa 2. 3 scoops of batter made from pulses to prepare chillas or adai 3. 3 curd, rasam or sambar vadas

4. 250 g khamman Items prepared from 150 g potatoes /100 g yam /200 g raw banana or One big scoop ice cream / one glass plain milk shake / 200 g fibrous fruit Please refer to the chapter titled “Eating Out and Junk Foods” for suggestions on how to indulge in junk foods, which should be eaten only occasionally and at dinner time as a meal (not frequently and in between meals as a snack).

Make sure that you do not eat more than 50 g of uncooked rice or wheat at dinnertime. Any more than this small quantity will make you put back one kilo of fat every month until you regain every kilo that you might have lost. As you settle down with this new system you will find that you are sometimes not hungry at bedtime, in which case, do not force yourself to eat high carbohydrate foods. Sometimes you may not feel hungry at lunchtime, in which case have either a lime soda, buttermilk, salad or fruit and eat only at night. What is important to note is that the body really needs only one high carbohydrate meal a day and you must reach this ideal stage in the days to come.

You might feel a little hungry for the first three days. Don’t be afraid of hunger. It is only an empty feeling in the stomach. We are changing the eating habits that you have formed over many years. When you feel hungry say to yourself, “Good, now I am giving my fat a chance to supply energy to my body”. Do you know that if you are 15 kilos overweight, you have two lakh calories in your fat just waiting to be used? If you put some food into your mouth every time you feel hungry, your fat will never get a chance to supply your body with energy. Besides, remember that your stomach is an elastic muscular bag. It is large because you have always filled it with large quantities of bulk food like rice and wheat. We would like your stomach to become smaller so that it is satisfied with smaller quantities of food.

Every hunger pang will make it a little smaller, so do not give in to the pangs! If you avoid paying attention to your hunger pangs they will disappear, but if you give in to them they will come at regular intervals and make you feel uncomfortable.

Some surgeons, in an attempt to make the stomach smaller, have operated upon and stapled the stomachs of obese people! If you follow all the advice given in this book, especially the chapter on how to eat, your stomach will automatically become smaller and you will be satisfied with eating small quantities of food.

If after a month of following the above regime, you find that you are not losing weight, then avoid eating pulses (except soya) at lunch time. Eat only the side dishes for lunch and eat the seeds, with or without mixing soya into them, at dinner time.

Fruit You may also eat any one fruit in your diet for lunch or dinner, instead of vegetables at lunchtime and instead of rice or wheat at dinnertime.

The carbohydrate in fruits replaces the carbohydrate from other foods.

Since fruits have more glucose in them than vegetables, they must be eaten in specified quantities. Choose one big fruit (about 200 g) from the following: apple, pomegranate, guava, orange, sweet lime, pear, peach, chikoo or two slices of papaya, pineapple, 100 g grapes (25 big grapes), a bowl of strawberries or watermelon. If the fruit is small you may have two of the same kind or combine two different fruits. If you wish to eat one fruit and one vegetable then eat half quantities of the fruit and eat very little vegetable. It would be safest to eat fruit with egg, fish, chicken, paneer, soya, 20 g cheese, 25 groundnuts, 13 almonds or 8 cashewnuts. You may make a fruit, nut and cheese salad and have it for lunch or dinner as a whole meal. If you do not drink tea or coffee in the morning, you may have half a fruit in the morning instead of the tomato juice. You may also have half a fruit in the evening, again only if you do not have tea or coffee. If one banana and a glass of buttermilk are sufficient, you may have this combination as a whole meal. Remember, fruits are not as filling as vegetables, so do not eat fruit when you are really hungry, because too much fruit will not allow you to lose weight. Do not combine fruits with high carbohydrate foods at the same meal.

Miscellaneous Foods You may include one of the following foods at either lunch or dinner, instead of vegetables for lunch and instead of rice or wheat at dinnertime. If you want to combine the foods listed below either with each other or with vegetables then eat only half the portions mentioned, with one small bowl of vegetables.

One packet popcorn (50 g), potato chips ( 60 g), root vegetables (150 g), unripe banana ( 200 g), sprouts (200 g), corn (30 g), cooked pulses (50 g), oats (50 g), one small ice-cream (100 g: a bar, a small cup or one scoop); or one milkshake. You may safely combine one of the above items with one of the following: egg, chicken, fish, 20 g cheese, 50 g paneer, 25 g soya, 13 almonds, 25 groundnuts or 8 cashewnuts. Notice that all these miscellaneous foods are conventionally considered to be snacks. Eat these snacks at mealtime as a part of your meal. This way you will find that you do not have to give up eating any of your favourite foods. Do not combine these foods with high carbohydrate foods at the same meal.

Notice that we are eating scientifically. The above mentioned foods have more carbohydrate in them than vegetables and must therefore be eaten in restricted quantities. If you learn how much carbohydrate each food contains and combine it with some protein, you can eat almost anything!

Try to include only one type of carbohydrate at every meal. Include either vegetables, roots or fruits at a meal, not all three. Observe nature: animals that live underground eat roots; they do not eat vegetables or fruit; those that live on land eat vegetables but do not eat roots or fruits; and the birds who eat fruit do not eat roots or vegetables. We have gone against nature by eating indiscriminately, all kinds of food, at all times and are today suffering the consequences of not thinking before we eat.

Do not eat cereals at lunchtime. It is the raw and cooked vegetables, fruit, paneer, nuts, pulses and soya that contain the most vitamins, minerals and antioxidants, not the cereals, and if we avoid cereals at one meal we will naturally fill up with more of these health foods, which will benefit the body.

Combining Oil, Protein and Carbohydrate at Lunch and Dinner Predominantly Carbohydrate Foods Choose any one of the predominantly carbohydrate foods listed below: 1. Vegetables: raita, soup, cooked vegetables 0r mushrooms with curd -unlimited 2. Root vegetables: 150 g potato, 100 g yam,80 g tapioca ,200 g carrot/ beetroot 3. Sweet fruit: 100 g banana, jackfruit, chikoo, grapes, custard apple or mango 4. Other fruit: 200 g 5. Potato chips: 60 g 6. Popcorn: 50 g or a medium corn on the cob 7. Pulses: 50 g 8. Baby corn: 150 g 9. Sprouts 200 g 10. Ice-cream: 100 g / one plain milkshake / coconut water and tender coconut / 170 ml soft drink 11. . Only for dinner : 50 gms cereals with 25 gms pulses

Predominantly Protein and Oil Foods Choose any one of the predominantly protein and oil foods listed below: 1. Paneer: 50 g 2. Tofu: 100 g 3. Soya: 25 g as channa, chilla, flakes or nuggets 4. Egg: one yolk and two whites 5. Fish: 150 g with bones 6. Chicken: 175 g with bones 7. Prawns: 75 g 8. Cheese: 20 g 9. Nuts: 25, groundnuts, or 25 pistas, or 13 almonds, or 8 cashewnuts A very effective way of receiving optimum protein and carbohydrate for the day would be to include some protein and carbohydrate at each

meal. Weight however goes down better if predominantly protein foods are eaten at lunchtime and predominantly carbohydrate foods are eaten at night. This has to do with cortisol levels in our blood which are lowest at night, thus allowing glucose to be fully utilized for energy at this time of day.

If we eat all the side dishes at lunchtime with 125 ml curd and any one item made from cereals and pulses at dinnertime we will be eating a wide variety of foods and our diet will be nutritionally complete.

Your weight reduction should be precious, like a treasure to be guarded well. Before you put a mouthful of food into your mouth think of how much carbohydrate it contains.

Sugar Jaggery Honey Rice Wheat Ragi Millets Pulses

99% 95% 79% 78% 72% 72% 68% 60%

carbohydrate carbohydrate carbohydrate carbohydrate carbohydrate carbohydrate carbohydrate carbohydrate

— only 1% less than honey!

— only 7% less than honey!

— only 7% less than honey!

— only 11% less than honey!

— only 19% less than honey!

Fruits, roots, peanuts and cashewnuts all have up to 25% carbohydrate in them. Even those animals that require more energy to dig, climb and fly only eat those foods which have up to 25% carbohydrate in them. We do not require this extra energy and yet we eat foods that contain from 60% to 99% carbohydrate. Is it any wonder that we suffer from obesity and become prone to adult onset diabetes mellitus?

The foods that this diet allows are those that contain all the vitamins, minerals and antioxidants. In addition, they provide the body with just the right amount of carbohydrate to suit our lifestyles, which have become so sedentary even though we are busy all through the day. Mental activity unfortunately does not burn up the excess carbohydrate present in high carbohydrate foods and if your body happens to be like the new model of a car that uses less petrol, then

you will find yourself putting on weight, if you insist on eating all the foods present in the traditional Indian diet, at all three meals.

Every spice used in Indian cooking has beneficial medicinal qualities. Traditionally Indians used sesame or groundnut oil for cooking. Today we know that these oils protect us against heart disease.

The traditional Indian custom of eating only twice a day, using groundnut or sesame oils and including in the diet, raw vegetables, curd, greens, a lightly seasoned vegetable, a vegetable made with pulses, cooked pulses, chutney, rasam and pickle is a very scientific diet. Relish these side dishes with only 50 g of rice or wheat at dinnertime. Only 40% of people with sedentary life styles and people involved in digging, pushing, carrying and running throughout the day can utilise excess glucose from large quantities of high carbohydrate foods at all three meals. Rice and wheat items by themselves are not palatable. Itâ&#x20AC;&#x2122;s what goes with them that gives taste. So, fill yourself with plenty of these side dishes. Make this minor mental adjustment, since our lifestyles have changed. If you donâ&#x20AC;&#x2122;t, you may well find yourself growing heavier and heavier until one day you sit up and wonder why!

Feed your children wisely. Make high-carbohydrate foods the side dish instead of the main dish and provide your children with double the usual quantities of side dishes at every meal. This way you will be fulfilling your duty as a parent by preventing the onset of obesity and perhaps diabetes in your offspring. You owe this to them.

5

Planning Your Own Diet It will now have become clear to you that you can eat everything, even high carbohydrate foods, if they are eaten in the right quantity, combination and at the right time. Refer to the section on food values and study it well. You may plan your own diet limiting your total carbohydrate intake to 145 g a day. Refer to the previous chapters on how to distribute it. This diet deals with eating the right food at the right time. Remember, high carbohydrate foods are best utilised by the body at night and not during the day as is commonly believed.

If you would like to become calorie conscious, then limit yourself to 400 calories per meal (lunch and dinner). Allow yourself 100 calories from the time of rising till lunch and another 100 calories between lunch and dinner. About four to five teaspoons of oil (2 teaspoons at each meal) would supply an additional 200 calories, making this a 1200 calorie diet.

Given below is a list of 100 calorie food portions for those who do not start the day with a cup of tea or coffee that would contain both milk and sugar. Choose any one portion and have it when you wake up in the morning. Then, do not eat anything else till lunchtime.

Approximately 100 calorie portions ( 1 cup = 150 ml) 25 g soya 1 scrambled egg 1 slice cheese 100 g homemade paneer/ 50 g readymade paneer 250 ml toned milk 125 ml chocolate milk 2 slices bacon 2½ cups popcorn 1 cup cornflakes without milk or sugar Half cup cornflakes with milk and sugar 1 cup puffed rice 25 g oats

1 big boiled potato / 8 potato chips / 6 French fries 25 groundnuts / 13 almonds / 8 cashewnuts 1 thin slice bread 1 large apple / orange / pear / guava / pomegranate / sweet lime / chikoo 2 peaches / 200 g strawberries / 20 grapes / 1 cup cherries / 4 prunes / 6 apricots 1 slice pineapple in syrup / 1 medium banana / 1 cup papaya / 1 cup watermelon 2 big tomatoes / 4 thin cucumbers / 2 carrots (6â&#x20AC;? or 15 cm)

TABLE 5.1 Food Values of Recommended Food Portions Food

Calories Protein

Carbohydrate Oil

Predominantly Carbohydrate Foods 400 g vegetables excluding roots 110

20

6

35

2.4

25

1.5

16

8

30

10

33

5.5

31.4

6.8

17.5

3

19.5

1.7

150 g potato

145 -

100â&#x20AC;&#x201C;200 g fruit (depending on the fruit)

125 -

200 g sprouts

72 -

50 g pulse

180 2.6

50 g corn

170 1.8

50 g oats

120 3.8

25 g wheat

86.5 -

25 g rice

86.25 -

12 g puffed rice (1 cup)

81.25

18.4

1.9

21

2

30

4.8

25 g cornflakes (1 cup)

97 -

35 g popcorn (3 cups)

140 -

Food

Calories Oil

Predominantly Protein Foods 100 g paneer (made from skimmed milk) 100 175 g chicken with bones 155 6 150 g fish with bones 100 2 25 g soya 108 5 Predominantly Oily Foods 50 g paneer (whole milk) 25 groundnuts 12 almonds 7 cashewnuts

146 11.5 85 6 99.75 8.8 89.4 7

Carbohydrate

Protein

8

13

-

25

-

20

5

10

4

6.5

4

3.8

1.6

3.1

3.3

3.2

Foods with almost equal portions of Carbohydrate and Protein 125 ml toned milk 70 7.5 5 2.5 125 ml toned milk curd 55 6 3.6 2 100 g mushroom 43 4.3 3.1 8 100 g green leafy vegetables 26 2.9 2 7

. .

Foods with almost equal amounts of Protein and Oil Egg (1 yolk + 2 whites) 100 6.5 75 g mutton with bones 97 8 20 g cheese 70 1.5 5

13 11 5

When you go through the chart on food values you will realise that 150 g mixed vegetable salad, a cup of curd, 150 g cooked vegetables, a soya wheat dosa or chapati and some non-vegetarian food may be eaten together at a meal to provide you with just 35 g of carbohydrate.

If you want to eat 50 g (two fistfuls) of rice or wheat, this one item alone will contain 40 g of carbohydrate and you must then restrict yourself to 10 g from other items, for example 200 g vegetables (excluding roots). This is what this diet is all about. Understand it and plan your own diet depending upon your individual likes and dislikes.

Feel good about the fact that you are now eating scientifically.

How many of you have actually cooked 50 g of rice? Cook this amount today, and you will find that this is the amount that most mothers would want their toddlers to eat at each meal! Incidentally, it contains the equivalent of 10 teaspoons of sugar. Would you rather fill your stomach with 400 g of nutritious vegetables, paneer and a soya dish or eat this small quantity of rice or wheat? Ponder over these facts and decide what you would wish to eat from day to day. Vary your diet so that you will know that you can eat almost anything you want.

When you combine â&#x20AC;&#x2DC;miscellaneous foodsâ&#x20AC;&#x2122; with each other or with vegetables you must eat only half quantities of only two of them i.e. half a fruit; half a packet of popcorn; 10 g chips; half a potato, 15 g corn; 15 g dal; 50 g ice-cream; 50 g home-made paneer or 25 g readymade paneer and have it with a small portion of vegetables.

Below are a few more combinations you might find interesting: Vegetables + popcorn Vegetables + fruit

Fruit + curd Fruit + paneer

Vegetable + ice-cream Vegetable + channa Potato + soya Potato + paneer Potato + tofu Potato + sprouts

Fruit + chips Fruit + popcorn Soya + sprouts Soya snacks + curd Sprouts + paneer Sprouts + fruit

As you go through the chart on food combinations, you will realise that you do not have to give up eating any of your favorite foods. Choose what you crave to eat from day to day and just wait for the right time to eat them, side dishes during the day and cereals at night.

Food Combinations at a glance If you want to lose weight, do not eat any item made from rice or wheat for lunch. If you are only interested in improving the quality of your diet, you may eat cereals and pulses which may have soya mixed into them for lunch and have them in the pure form at dinner time.

Choose any one item from each column in the following table and eat them for either lunch or dinner. The left column contains predominantly low carbohydrate foods and the right column contains predominantly protein foods.

TABLE 5.2a Lunch or Dinner Choose any one of the following: Raw vegetables, cooked vegetables, 125 ml curd

:

200 g fibrous fruit: apple/pomegranate/ watermelon/pear/peach/ plums/pineapple/papaya/ guava/orange/sweetlime 100 g fleshy fruit: mango/

Choose any one of the following: 50 g ready-made paneer

100 g low fat (home-made) paneer 100 g tofu

15 g nuts â&#x20AC;&#x201C; 13 almonds/13 pistas/ 2 walnuts/ 25 groundnuts/ 8 cashewnuts

25 g soya chana/soondal/

jackfruit/chikoo/grapes/ custard apple/leechi/ mangosteen/ banana 50 g popcorn/corn 150 g potato/200 gunripe banana/ uttamam/ carrot/beetroot 60 g chips/16 french fries 50 g dal — chana/papad/ vada/sprouts 100 g ice-cream/ plain milk shake 170 ml soft drink 50 g sweets/chocolate 200 ml coconut water with tender coconut 4 cream biscuits

30 g pulses made into uttapam or chilla 50 g soya/wheat — chapati/dosa 50 g soya/chana dal — pakoda/vada 30 g soya flakes — pulav/uppuma 30 g soya nuggets 20 g low-fat cheese Egg – 1 yolk with 2 whites 150 g fish with bones 170 g chicken with bones 75 g prawns

TABLE 5.2b Only Dinner Choose any two side dishes:

Choose any one only:

Raw vegetables, cooked vegetables, 125 ml curd 50 g sprouts 100 g mushrooms

3 idlis/dosa (from 3 scoops batter) 50 g rice 3 chapatis/puris/parathas (lime-sized dough for each) 50 g rava/vermicelli 50 g noodles/pasta/macaroni 30 g chana/oats 2 slices pizza/2 slices bread 2 puffs/2 samosas/3 curd or rasam vadas 1 plate bhelpuri/chaat/

50 g ready-made paneer 100 g low-fat paneer/tofu Egg – one yolk and 2 whites 150 g fish with bones 175 g chicken with bones 75 g prawns

15 g nuts 20 g low fat cheese

panipuri/ pav bhaji 30 g cornflakes (without milk or sugar) 12 g puffed rice

(about 150 ml cup) 35 g popcorn/corn/chips 100 ml ice-cream/ plain milk shake/50 g sweets 200 g fibrous fruit

Here are the menus of a few people who love to eat in a new way!

In fact, they feel that it is a nice way to eat. You will see that you can eat all your favorite foods and still remain fit and healthy.

(N. B. s.w. = soya wheat) TABLE 5.3a Karthika, 8 years, non-vegetarian

TABLE 5.3b Anupama, 21 years, vegetarian

TABLE 5.3c Vishal, 22 years, non-vegetarian

TABLE 5.3d Shyamala, 33 years, vegetarian (eats eggs)

TABLE 5.3e Selvi, 31 years, non-vegetarian

TABLE 5.3f Kamini, 47 years, non-vegetarian

6

Good Food, Bad Food Eating Out and Junk Foods White rice and maida are Indiaâ&#x20AC;&#x2122;s most frequently eaten junk foods.

They contain the highest amounts of carbohydrate (78% and 72% respectively), the least protein amongst cereals and pulses (7% and 12% respectively) and they are highly polished (white and shiny) and so have lost most of their vitamins, minerals and fiber. When these foods are combined with refined sugar, hydrogenated fats (dalda or margarine) and saturated fats ( cream, butter, cheese and ghee) as in buttered cheese, sandwiches, pizzas, biscuits, Indian sweets, cakes and processed foods like noodles or pasta, they become all the more unhealthy.

Having said this, the above items will not harm us if they are eaten occasionally, say once a week and at dinner time as the main dish.

They must not be eaten frequently and should not be eaten in between meals as a snack. Soft drinks are also junk foods. Deep fried foods that have not been prepared at home are junk foods because they have in all probability been fried repeatedly in wrong oils. This increases our intake of trans fatty acids that would increase the LDL (bad cholesterol) which would predispose us to cardiovascular diseases.

Recommended portions of some maida items that may be eaten occasionally and at dinner time are: 3 small maida puris or bhaturas; 50 g noodles/pasta; 2 slices maida based pizza; 4 slices white bread; one small burger; one portion of pav bhaji; 2 plates pani puri; one plate bhel puri; 2 small samosas or puffs; one naan / romali roti or maida paratha / dosai; 50 g Indian sweets; one pastry or a small soft drink or mocktail. Choose any one of the above and eat them with healthy low carbohydrate side dishes and some protein.

Notice how a doting mother prepares maida puris, parathas and bhaturas for her children and lovingly serves them with potatoes or channa. She has combined preparation made from maida, which is a high carbohydrate item with high carbohydrate side dishes (channa and potatoes) instead of low carbohydrate or protein foods, thus making her offspring susceptible to obesity which might insidiously make its appearance in the future. How many of us parents are or have been guilty of preparing noodles, macaroni or pasta (maida and hydrogenated oils) as a substitute for a healthy meal, just because children love the taste (remember the TV advertisement - maggi maggi maggi!) and it’s oh, such a quick solution, when we just don’t have time or don’t feel like cooking. Also, most households will usually have a loaf of white bread in the refrigerator so that it may be used to prepare a quick snack or even a meal.

When you are at a restaurant or somebody’s home for lunch, eat the soup, salad, curd, vegetables, mushrooms, paneer, fish, chicken, shellfish and egg. Vegetarians may also eat pulse preparations such as channa, adai/chillara, vadas or dhoklas. When you are passed the rice, chapati or noodles show your friends your filled plate and tell them that you will take those items later. If absolutely necessary, help yourself to a small quantity of high-carbohydrate foods so that you do not feel deprived of tasting them. Then make sure that you avoid eating those foods again at dinner time. It is all a question of being aware of which foods could harm you and balancing your intake.

When you are a guest in someone’s house do not tell anyone that you are deliberately avoiding certain foods. Nobody is really concerned about your extra weight and people will force you to eat wrong foods if you draw their attention to your diet .Fill up your plate with all the dishes present, except those that are made from either rice or wheat and show people that you go for second helpings. If you have to choose between idli, dosa and vada, choose the vada (dal has a lower carbohydrate content, a lower glycemic index and contains more fibre than rice) preferably vadas that have been immersed in curd or rasam.

When you are invited out, or to a wedding reception, eat all the side dishes. Ask to be served only a small quantity of rice. Eat the recommended quantity as has been explained and leave the rest, folding your banana leaf over it. So much food is wasted even by

those who eat everything, nobody will be offended by your leaving this small quantity of rice.

I’m often asked, ‘But doctor, won’t I miss eating all my favourite sweets, pastries and chocolates during the day?’ Have you ever tried to relish these items mentally? Do it right away! Visualise your favorite sweet dish in detail. The colour, shape, texture and smell. Don’t you already feel your taste buds tingling? It’s almost as though you are tasting it right now, in your mouth. I want you to repeat this mental exercise many times a day with all your favorite foods. It’s amazing how satisfied you will feel to know that you can taste everything, anywhere, without having to take the trouble to buy the food and actually put it into your mouth. Notice how you very often don’t feel like eating the food that you have prepared yourself. You have already spent time looking at it and smelling its aroma, and this seems to have killed your appetite; you feel that you have already tasted it.

In fact, before you settle down to a meal mentally visualise each item on your plate. Take time to mentally savour each dish before you actually eat it. Once you have done this, you will find that you are satisfied with eating much smaller quantities.

If you long for a little sweet or chocolate, have a bite before you begin your meal. You will be able to taste everything this way without being tempted to eat large quantities. If you have that small bite at the end of your meal, your appetite will return and you will want to finish the whole sweet or chocolate. Bite into it, suck it slowly, roll it around and allow it to melt in your mouth, before you swallow it. Notice how people drink wine. They smell it first, then they sip it, swirl it around in their mouths, and savour its flavour on their palate before swallowing it. Eat and drink graciously. Develop the art of savouring and relishing your food in a leisurely manner. Surely this is a more refined way to eat compared to gulping your food down in large quantities without first tasting it.

Soft drinks, biscuits, pastries, chocolates, sweets, chips and deep fried foods have caused irreversible damage to the health of our children due to saturated fat, transfatty acids, refined flours and their high-carbohydrate content. Do not feed your children these foods on a daily basis. They will become addicted to various exotic flavours and one day, if they become overweight, they will find it impossible to do without them. Take your children out at the weekend and give them a treat; in other words, indulge them once a week. It is not their fault but yours if they indulge in these items at home. It is not your duty as a parent to have a well stocked refrigerator so that the children can help themselves to whatever they want whenever they feel hungry.

They are watching you and will eat what you eat. If your eating habits are bad, your children will not see a reason to believe what you tell them about eating scientifically.

Teach your children about high carbohydrate foods and how to balance their meals with some protein and plenty of low carbohydrate foods. Soya, paneer, fish, chicken, shellfish and eggs are predominantly protein foods. All other foods are predominantly carbohydrate foods. Give your children foods that nature has intended for us to eat and you will be giving them the most precious gift of all— good health.

WEDDINGS AND FUNCTIONS Usually South Indian weddings serve Idlis and Vadas for breakfast. Choose the vadas over the idlis ( people invariably do the opposite, because vadas are fried and idlis are steamed.) Remember it is not the oil that is the problem, it is the carbohydrate. Rice has 78% of carbohydrate and dhal ( from which vadas are made ) has just 60%.When lunch is served, eat all the side dishes including the pulses ( papad, channa ) but avoid and the rice and wheat.

WHEN YOU ARE ILL Don’t make illness an excuse to change your diet. Not all medication needs to be taken on a full stomach. Only anti inflammatory drugs should never be taken on an empty stomach. In our diet the stomach is never empty; in fact some food or liquid enters it every two hours. Just because we don’t eat rice and wheat during the day it doesn’t mean that the stomach is empty. Take your morning dose of medicines after our breakfast of fruit and nuts and then the next does after lunch and dinner. Drink hot soups instead of salads in case you want to, at lunch time and have any fibrous fruit instead of tomatoes, cucumbers and guavas in the morning, if you wish.

HOLIDAYS Its common to hear “ Sorry doctor, I was out of station on holiday and couldn’t follow the diet “. Well, let me give you a few ideas about how we can follow the diet, even if we are on holiday. Have your tea or coffee on rising; breakfasts are usually included in a holiday package.

So head to the dining hall to select a fibrous fruit and some protein like

coldcuts or egg for nonvegetarians or cheese for vegetarians. Always carry a zip bag filled with almonds, pistachios, walnuts and soya nuts, so that you might munch them along with your fruit. Pack as many tetrapacks as your days of travel, of Amul Masti Buttermilk, in your check in luggage; carry one with you in your handbag and drink it at about 12 noon. For lunch at a restaurant, order clear soup, salads, cooked vegetables, mushrooms and any one protein as described.

We will even eat the pulses for lunch when we are away from home.

So you may have a channa, chilla,, vada or papad. Just don’t eat anything made from rice or wheat and try to avoid the sweet for lunch.

Carry another zip bag filled with roasted groundnuts so that you can have a fistful of them in the evening along with your tea or coffee; and everything is allowed at dinner time.

FOOD LABLES Be very discriminating when you read food labels. Do not be carried away by labels that say ‘ No added sugar ’ The ingredient has its own natural sugar which if excessive, is as harmful as ‘added sugar’. It is therefore not sugar free ! Do not be carried away by ‘ fat free’ labels if you are looking to lose weight or control blood glucose levels. Always examine the label for the carbohydrate content. Carbohydrate and sugar are the same. If it is a fruit juice or snack you should not consume more than 7 g of carbohydrate at a time in between meals; that would be just 50 ml of a packaged juice; not the whole 200 ml tetrapack unless it is combined with a predominantly protein food and taken at meal time instead of other high carbohydrate foods. About fifteen years ago cornflakes was advertised as ‘ fat free ’ and parents bought it for their children, presuming that it was a healthy breakfast cereal. Corn has 68% carbohydrate in it and added to the cornflakes are raisins and other dried fruit. Cornflakes is then eaten with milk and sugar; the final product when consumed, has more glucose in it than rice !

Now we come to biscuits. We are lured to buy biscuits that are labelled ‘ flax seed ’ or ‘ oats biscuits ’ . There may be just a sprinkling of flax seeds over the surface and there may be just 20% oats mixed

into the flour ! These are advertising tricks to induce us to buy products. To know how much carbohydrate is present in one biscuit, read the label to find out how much is contained in 100 g. Then find out how much the packet weighs. Count the number of biscuits in one packet and calculate how many biscuits in 100 g. Then divide the carbohydrate content in 100g by the number of biscuits in 100gms.

Don’t eat more than 5 g of carbohydrate at a time as an in between snack if you want to lose weight. Similarly, you might buy a packet of ‘ soya murukkus or soya biscuits ’ which may contain just 20% soya.

Don’t buy items that contain sugar substitutes. It has already been explained that they contain chemicals and may be more harmful than real sugar. This includes diet soda, jams, chewing gum and diet cokes.

Remember cholesterol is only found in the animal kingdom, so its no big deal to read that a vegetarian product is cholesterol free ! It’s the saturated fat that you should look out for. It is saturated fat that may increase the bad cholesterol. Don’t be taken in by labels on oil containers that read ‘ triple refined; cholesterol free ‘ and have a picture of a heart beneath it. Remember, all vegetable oils are cholesterol free, whether unrefined or refined. A pure looking oil is not healthy. It has been heated to refine it and it is reheated when we prepare food which produces transfatty acids which increase the bad cholesterol. In fact, the darker, thicker and smellier the oil, the better it is for health. Ask your grandparents which oils they used. They would reply ‘ unrefined gingelly ( sesame ) and groundnut oils ‘; and India was not the heart attack capital of the world fifty years ago.

Always buy whole wheat flour that has not been refined. Don’t be carried away by labels that read ‘ wheat bread ’or ‘wheat biscuits ‘.

Refined flour ( maida ) is also wheat. The label should read ‘whole wheat ’.

Remember, the only vegetarian foods that have a predominantly protein content are soya , cheese and cottage cheese ( paneer ).. So when you read a label that says â&#x20AC;&#x2DC; high protein â&#x20AC;&#x2122; check what it contains.

Pulses contain 20% protein; wheat and oats about 13%; millets 11%; ragi and rice just 7%. So items containing these ingredients cannot be high in protein. All these items are predominantly carbohydrate foods.

Soya on the other hand contains 40% protein and just 20 to 30% carbohydrate; cheese contains 24% protein and 6% carbohydrate and cottage cheese is also a predominantly protein food with 13% protein and 8% carbohydrate. Always consume a low fat cheese and make paneer at home using low fat milk to cut down on saturated fat which is found in milk products. It is not necessary to consume skimmed milk. Some cholesterol is required to be present in the diet, especially in vegetarian diets. Cream contains Vitamins A and D which are not present in other vegetarian foods. Do not consume products which contain soya protein isolate, for the reasons already given in a previous chapter.

Eating for Good Health Now that I have told you what you may eat, I will teach you how you must eat; this too is very important. Make sure that whatever you eat is tasty so that you may enjoy your diet. For it is only if you like your diet that you will continue to follow it for life and that is what you must do. Remember, old diet, old weight. We cannot change your metabolism or your nature, which determines how active you are. We can only help you to reach your ideal weight by changing your eating habits. So if you go back to your old eating habits you will regain all the weight that you have lost. Never forget this.

In this system which allows you to use oil, no particular method of food preparation is required. This is not a bland, boiled-food diet. Use all the masalas that you may need to prepare tasty food. Remember, we are not running away from food. In fact, I want you to enjoy your food as you have never enjoyed it before.

I want you to observe how animals eat. Carnivores do not chew their food. They gulp it down because protein is digested in the stomach. It is the herbivores that chew their food well. Take an example on how to eat from the cow, goat, camel and horse. How well they chew! It is because nature has placed both teeth for grinding and saliva for the digestion of carbohydrate in the mouth.

Chew well and eat slowly, so that a maximum amount of saliva is secreted and mixed with the food before it is swallowed. Ensure that at least 15 seconds elapse between mouthfuls of food. Chew food to liquid consistency before you swallow and get up from a meal feeling light. Saliva converts carbohydrate into glucose and if this happens effectively, the glucose is immediately absorbed into the blood and it makes one feel more energetic after eating, instead of sleepy and lethargic, which is usually the case.

The tongue with its taste buds has been placed in the mouth to help you enjoy food. The stomach cannot tell the difference between grass and biriyani! So eat slowly—appreciate and relish what you eat. Do not talk or even think of other things when you eat. In fact, when you sit down to a meal, your attitude should not be ‘to eat’ but ‘to taste’ everything. Tasting requires just a few teaspoons of each dish, provided each spoonful is truly savoured.

Try to eat using a bowl and spoon. Place both down between mouthfuls of food. This way you will automatically chew in a leisurely

manner and will not swallow quickly. Make sure that your mouth is completely empty before you fill it up again! If you eat this way, some carbohydrate will be converted into glucose by the action of saliva in the mouth. This glucose will begin to get absorbed and enter the blood slowly. The body will use it for its energy requirements.

However, if you eat quickly, all the glucose will be absorbed into the blood rapidly, since carbohydrate digestion will take place mainly in the intestine. Blood glucose levels will go up quickly and the excess glucose will be converted into fat or will be manifest as high blood glucose in those prone to diabetes.

If we eat slowly, we can become aware of our stomachs filling up and we will stop eating as soon as we perceive that we are not hungry. When we eat quickly we stop only when we realise that we have overeaten and by then, it is too late to do anything about it.

It has been observed that at mealtimes, people eat continuously and stop eating only when 20 minutes are over. It appears that the feeling of satiety requires 20 minutes of tasting. If you eat quickly, you will fill your plate many times during those 20 minutes. If, on the other hand, you eat slowly, you will also taste food for 20 minutes, but you will eat much less.

Therefore, eat for a period of at least 20 minutes at each meal.

Notice how, at a party, people who eat fast refill their plate many times, while those who eat slowly and relish their food, eat for the same period but never have to go for a second helping! If you eat slowly and deliberately, you automatically eat less. Don’t continue to eat once you feel full. We do this because we feel that food should not be wasted. Once food is digested, what is not absorbed will definitely turn into waste! All the excess food you absorb is also wasted since it turns into fat. So resist the urge to ‘finish it all up’. If you do not want to keep left over food, put it on a window sill or balcony, the birds will gratefully finish it for you.

Once you are full, you may if you wish continue to pamper your taste buds by slowly sipping a tasty rasam or buttermilk. If you eat slowly and relish your food you will not feel hungry for hours. As the days go by you will not even feel like eating at dinnertime and you may go to bed with just a few mouthfuls of food for taste.

The traditional Indian posture of sitting on a slightly elevated platform on the floor and bending forward while eating out of a banana leaf, which is placed at some distance from the body, automatically prevents one from overeating, since, when bending forward to place a morsel in the mouth, the chest is bent over the upper abdomen which naturally compresses the stomach. Also, the custom of not finishing before the elders have finished compels one to eat slowly and consequently to chew for a longer time.

An incident that took place in a monastery in Leh comes to mind: a Western traveller was intrigued by the manner in which each monk partook of his food. A small quantity of food would be reverently placed upon each plate. Each monk would them set himself down in an isolated spot to partake of his meal. Each mouthful of food would be chewed many times and savoured completely before being swallowed. When questioned about this, the head of the monastery explained that, if food was not chewed to a pulp and mentally savoured, the products of digestion, when absorbed into the blood, would more likely be converted into fat, rather than be used for

energy. This is why, he explained, people who eat large quantities of food in a hurry are usually unhealthy, lethargic and obese.

Remember, what matters is not how much food you put into your stomach, but how long you have savoured it in your mouth. If you swallow a mouthful of food without tasting it, you have wasted it.

MYTHS 1. Eating raw tomatoes, especially the seeds will result in stones in the urinary system 2. It is necessary to drink two to three litres of water per day 3. Honey and lime will cause weight reduction 4. It is necessary to drink skimmed milk 5. Nuts and vegetable oils contain cholesterol and cause weight gain 6. Unrefined oils contain cholesterol 7. Egg yolk should not be eaten 8. Paneer is fattening 9. Cholesterol in the diet results in high cholesterol levels in the blood 10. One should not sleep immediately after eating 11. It is necessary to exercise with machines and weights 12. One should eat like a king in the morning and a beggar in the night 13. Pulses are predominantly protein foods 14. There is such a thing as a “ detox diet “

7

Syndromes Related to Obesity There are many conditions like insulin resistance, diabetes mellitus, ovarian disease, hypothyroidism, stress and other metabolic disorders which, if present, have to be treated simultaneously with weight reduction. If neglected they will not allow you to lose weight even on this diet. Steroids alter the metabolism of the body in a way that greatly hinders weight reduction. Those who have taken steroids at any time will find that their weight reduction will be very slow even on this diet.

Insulin Resistance One in four people today have developed insulin resistance. This means that the insulin receptors no longer respond efficiently to insulin and, consequently, less glucose is carried into the cells for energy production. This results in more glucose in the blood which is stored away as fat. The pancreas, in an attempt to compensate for this defect, secretes more insulin. High levels of insulin increase total and LDL cholesterol, decrease HDL cholesterol, increase triglycerides, and uric acids promote clotting of blood in the blood vessels, causing vasoconstriction and predisposing us to hypertension and decreased insulin sensitivity, which leads to diabetes. This condition is known as Syndrome X. Insulin resistance is caused by genetic, environmental, dietary factors like a high carbohydrate diet, diabetes in the family, PCOD, and factors of lifestyle such as stress and sedentary living.

This condition is easily diagnosed by checking fasting insulin levels in the blood which should not exceed 9 micro units/ml. Another parameter to determine Insulin Resistance is the HOMA - IR value.

This is calculated by multiplying the results of fasting glucose by fasting insulin and dividing by 405 If the result is above 3.8, a diagnosis of Insulin Resistance may be made.

One of the most wonderful benefits of this diet is that elevated insulin levels revert to normal in about 80% of those who have elevated

levels. The fasting serum insulin may be re-checked after two weeks of following this diet and if the insulin levels remain elevated, then metformin may be administered under medical supervision.

Hypothyroidism Hypothyroidism may be primary when the thyroid gland, which is situated in the neck, fails to produce an adequate quantity of thyroid hormones. It may also be secondary, when the thyroid stimulating hormone (TSH) which is secreted from the pituitary gland in the brain, fails to stimulate the thyroid gland, which consequently produces less of the thyroid hormone. The thyroid hormones regulate metabolism, and when deficient or ineffective, lead to a number of metabolically related symptoms.

Symptoms Obesity, early morning fatigue, muscle weakness or cramps, stiff joints, headache, fluid retention, constipation, depression, memory loss, loss of concentration, a feeling of cold especially in the hands and feet, dry coarse skin, brittle nails and irregular or heavy menstrual periods.

Investigations Hypothyroidism is easily diagnosed by a blood test that would measure the levels of the two thyroid hormones â&#x20AC;&#x201C; Free T3 and Free T4 â&#x20AC;&#x201C; and also the thyroid stimulating hormone, TSH. Antibodies to the thyroid gland could also be measured.

Treatment Hypothyroidism is easily treated by administering the thyroid hormone orally first thing in the morning on an empty stomach. When this condition is treated adequately it becomes easy to lose weight by following the diet.

Polycystic Ovarian Disease (PCOD) PCOD is becoming increasingly common in young, overweight teenage girls. This condition is diagnosed when multiple tiny cysts appear on the surface of both ovaries, which are sometimes enlarged.

These cysts interfere with the normal secretion of female sex hormones and consequently ovulation and conception. Sometimes, excessive amounts of male androgenic hormones are also secreted and insulin resistance is also present.

Symptoms Insulin resistance leads to obesity while irregular periods, anovulation and infertility result from disturbances in hormone production.

Excessive growth of facial hair results from excess androgen secretion.

Investigations PCOD is easily diagnosed by an ultrasound of the lower abdomen, which will clearly demonstrate the cysts. A blood test would detect abnormal hormone levels and the fasting serum insulin level might also be elevated demonstrating insulin resistance.

Treatment Weight reduction is the single most important factor in the treatment of PCOD. Once weight is reduced, the cysts regress and consequently, hormone secretion becomes normal. Metformin is administered, under medical supervision, to treat insulin resistance and female hormones are administered to regulate menstruation. Regular to moderate exercise has also been found to be helpful.

Adult Onset Diabetes Mellitusâ&#x20AC;&#x201D;Type 2 This is a hereditary disease which usually manifests after the age of 40 ( although it is diagnosed at much younger ages today ).

Gestational diabetes ( diabetes that manifests during pregnancy ) is also becoming increasingly common. Diabetes is characterised by

high blood glucose levels which result from either a deficit in insulin production or insulin action, or both.

Symptoms This condition is very often symptomless and is apt to remain undiagnosed. It manifests insidiously as obesity, thirst, frequent passing of urine at nght, tiredness, delayed healing of wounds, and frequent urinary tract or skin infections. Sometimes it is only diagnosed when irreversible damage has taken place in the arteries, nerves, heart, brain, kidneys and eyes.

Investigations Everyone above the age of 30 and especially those who have a family history of diabetes mellitus must check their fasting and, if possible, post-prandial (1½ hr after food) blood glucose levels at least once a year. All pregnant women too must have their blood glucose levels checked. The glycosylated haemoglobin ( HbA1c ) test measures the average blood glucose level for the previous three months and is invaluable in diagnosing diabetes mellitus and in monitoring its control.

Treatment The single most effective factor in the prevention and treatment of diabetes mellitus is the diet as outlined in this book. Following this diet ensures that blood glucose levels are immediately lowered which is why it must be followed only under medical supervision, since the dosage of certain medications ( especially those medications that stimulate the pancreas to produce more insulin ) may have to lowered or avoided completely. If blood glucose levels do not return to the desired normal range, oral hypoglycemic drugs or low doses of insulin may be administered under medical supervision. Regular fasting and post prandial blood glucose levels must be carried out and the results reported to your physician.

Cushing’s Syndrome Cushing’s syndrome results from the prolonged administration of steroids. This occurs most commonly when steroids are administered to patients to relieve them of painful, distressing symptoms which result from a number of chronic incurable diseases like rheumatoid arthritis, bronchial asthma and intractable skin diseases. Sometimes patients are not informed by their doctors that they have been given steroids and it is only when the symptoms of irreversible metabolic changes manifest, that they realise that they may have been administered these potent hormones. Less commonly, Cushing’s syndrome results from the overproduction of steroids within the body as is seen in pituitary or adrenal growths. This condition will not be discussed here.

Symptoms Obesity with fat distribution confined to the chest and abdomen, moon face, a hump at the back of the neck, stria (lines) radiating outwards from the navel, thin skin, muscle weakness, excessive facial hair, frequent infections and irregular menstrual periods are some of the manifestations of this syndrome. Hypertension and glucose intolerance with insulin resistance may also result from Cushing’s syndrome.

Investigations Since investigations are usually carried out long after the administrations of steroids, blood tests to measure cortisol are usually normal. A diagnosis is therefore made on careful past history and clinical examinations. Fasting serum insulin levels may be elevated, indicating insulin resistance.

Treatment This condition is not easily treated and weight loss is not always possible. Even if this diet is followed, the results are unsatisfactory due to irreversible metabolic changes that have taken place in the body.

Metformin â&#x20AC;&#x201C; to be taken under medical supervision â&#x20AC;&#x201C; can overcome the insulin resistance that is invariably present.

Obesity-related Metabolic Disturbances Extra weight in itself can result in metabolic disturbances relating to disturbed hormone, neurotransmitter and enzyme production. Those disturbances could, in turn, lead to chronic obesity. Unless these disturbances are accurately diagnosed and treated, 30% of overweight people will either not lose weight or will rapidly regain it even while continuing to choose the right quality of food. But I do believe that most metabolic disturbances can be restored to normal in time, provided the diet is low-calorie and truly balanced, including all the food elements necessary for good nutrition. Moderate but regular exercise plays an important role in maintaining a healthy metabolism.

Nowhere does the importance of preventive medicine become so evident as in the prevention of obesity and all its subsequent complications.

Trying to Lose Weight the Second Time Those who have lost weight in the past by following a diet or consuming shakes that contain soya protein isolate and have regained the weight they lost, may not lose weight again rapidly, even if they follow this diet. Natureâ&#x20AC;&#x2122;s strongest instinct is to survive and it does this by adapting itself to its environment. When we change our food habits, our body perceives an environmental change and slowly adapts itself to this change, by using alternate metabolic pathways. Therefore, when people lose weight by changing their food habits and then regain all the weight they have lost by reverting to their original diet, they find it very difficult to lose weight the second time. The lesson to be learnt is that if you are overweight or diabetic, you must change the way you eat forever. Weight reduction is not a treatment or a cure. It results from eating in a new way, for the rest of your life.

If you are dieting for the second time and find that you are not losing weight, perhaps you are eating too much of the right foods at each meal. Make only one dish and eat only that dish at that meal. If we

have a variety of items before us we automatically eat more, for each new item is so delicious and hunger is not satisfied until we have finished everything. On the other hand, if only one dish is visible on the table, we eat it and automatically feel satisfied earlier since it is boring to continue tasting the same dish for so long. Also, before you put a teaspoon of food into your mouth, ask yourself if you are really hungry. If you are not, do not eat it. If you do however want to pamper your taste buds, mix a little pickle or tasty curry into a little curd or dal (just a teaspoon) and taste this by licking it off the bowl of a spoon. It will satisfy your taste buds without your body getting any extra food.

Stress-related Obesity It is well known that stress causes the body to secrete corticosteroids that cause glucose intolerance. This means that the body’s capability to utilise glucose is decreased. If the body is unable to utilise glucose, glucose requirements are reduced and therefore glucose from the diet is converted into fat. Stress also predisposes us to diabetes and cardiovascular disease.

Today our lives are very stressful, both at home and at work.

Sometimes we cannot escape from problematic situations and we become stressed subconsciously. Regular exercise, yoga, breathing exercises and most importantly self enquiry into core concepts that when invalidated cause distressing thoughts and emotions, help relieve stress. A serious reading of the following books is also recommended: • • • •

The Road Less Travelled - by M. Scott Peck What are you doing with your life? - by J. Krishnamurthy The Power of Now - by Ekhart Tolle Many Lives, Many Masters and Messages from the Masters - by Brian Weiss • Call to Love - by Anthony de Mello, S. J. • How to Have What you Want and Want What you Have - by John Gray • Who am I - by Ramana Maharishi

8

Adult Onset Diabetes Note: As this diet entails reducing or stopping medication for diabetes, it is extremely important for diabetics to begin and to follow it only under medical supervision, and to adhere to it faithfully. This chapter is especially intended to guide physicians who may want to recommend this diet to diabetic patients

All borderline diabetics and those who have just started medication may begin this diet straightaway (after stopping or reducing their medication under medical supervision ); metformin however may be continued if there is insulin resistance since metformin makes the insulin receptors more sensitive to insulin and will not result in low blood glucose levels.

In most cases, blood glucose levels will be normalised immediately. Those diabetics who have been on sulphonylurea drugs (that stimulate the pancreas to make more insulin) for a long time, or who are on insulin, should do so in consultation with their diabetologist after carefully considering the following facts.

Paramount in the management of diabetes is good blood glucose control, whether by diet alone, or with medication which may include insulin. Before you start this diet, consider whether you have the will and determination to adhere to it all your life. In the case of those suffering from obesity an occasional deviation will not matter. For diabetics, even occasional deviations do matter, for your blood glucose level will be immediately elevated when you deviate, and this can be dangerous since you may have lowered or discontinued your medication!

The advantage of this diet over the diets that are usually recommended for diabetic patients is that hunger disappears.

Since no insulin is injected during the day from the very first day, there is no hunger and no fear of hypoglycemia. Not eating a

high carbohydrate breakfast is one of the most important factors contributing to good blood glucose control. Restrict yourself to tea or coffee either without sugar or a half teaspoon of sugar, tomato juice, cucumber, guava or pineapple along with a fistful of soya nuts, 6 almonds, 8 pistachios or two walnuts and a rasam, buttermilk or lime soda (salt), as explained in the previous chapters, till lunch. Then follow the diet as has been explained in Chapter 4. You will also be able to lose weight on this diet and this itself will improve your glycemic control and will benefit many weight-related complications like hypertension and heart disease.

Once you have made up your mind to start this diet you must be in constant touch with your diabetologist for the first few days, reporting to him or her, your fasting and post-prandial blood glucose levels, so that you know that your blood glucose is well under control. High carbohydrate foods like rice, wheat and pulses should be mixed with soya if possible and eaten only at night. Rice, wheat and any item containing sugar are slow poisons for a diabetic and the effects of elevated glucose in the blood which result from eating these foods, only manifest years later. If possible, items made from rice and wheat could be totally avoided if blood glucose levels are not sufficiently lowered.

Given below is a recipe for idli or dosa which has proved to be excellent for those who have diabetes: One measure soya Half measure idli rice Half measure urad dal Quarter measure mung dal â&#x20AC;&#x201C; slightly roasted Soak all the above ingredients together overnight and grind them in the morning. Ferment the batter and prepare idlis and dosas as usual.

The best glucometer should be purchased. It does not matter if it is expensive; your future wellbeing depends on accurate blood glucose readings. NO INSULIN should be injected in the morning or afternoon from the very first day of this diet. It may be administered before dinner at half the previous dose If this instruction is not followed, there is a very real risk of hypoglycemia and coma. Oral medication must be continued at optimum dosages,. Fasting and post-prandial blood glucose levels should be diligently monitored every day under the supervision of your diabetologist. If blood glucose levels are not satisfactorily lowered, then insulin dosage may be increased before dinner and insulin may be reintroduced, starting with one fourth of the original dose in the morning and adjusted depending upon each individual case.

Those who are not on insulin must lower their oral medication from the very first day of this diet. Only Metformin may be needed to be continued on a regular basis, since this drug helps the body to utilise glucose better, as it improves insulin sensitivity and does not result in low blood glucose. .

Those who have juvenile diabetes will not be able to completely avoid insulin, since their bodies do not produce any insulin at all. But their doses of insulin will be considerably lower on this diet.

Those who have diabetic nephropathy (which would be indicated by increased levels of urea and creatinine in the blood or protein excretion in the urine) should consider the following diet modifications in consultation with their nephrologists: 1. Protein intake should be reduced to 0.6 g/kg/day.

2. All pulses should be consumed in dilute form to decrease protein and phosphates in the diet.

3. Adequate protein may be obtained from low fat milk, curd, home-made paneer and egg whites.

4. Only 25 g soya should be consumed per day mixed into either idli or dosa batter or wheat flour. These items may be eaten at dinnertime.

5. Vegetables to be avoided include cauliflower, capsicum, radish, drumstick, turnip and baby corn.

6. If there is a sodium/potassium imbalance, then tomatoes, leafy vegetables, cabbage and mushrooms must also be avoided until the balance is restored.

7. Plenty of gourds, ladies fingers and brinjals with curd, homemade paneer and rasam must be for lunch.

8. Non-vegetarian food should be eaten in small quantities and only occasionally.

9. Salt should be reduced.

10. Nuts and coffee containing chicory should be avoided.

TABLE 8.1 Protein intake Foods

Protein

500 ml low-fat milk 25 g soya bean 25 g other pulses 50 g cereals Total Protein

20 g 10 g 5g 5g 40 g

Apart from substantially normalising elevated blood glucose levels, increased cholesterol and triglyceride levels are also lowered on this diet and, in many cases, diabetic patients previously on insulin may lead the rest of their lives without having to depend upon it to control their blood glucose levels.

To end on a note of caution, all diabetics are advised to be in constant touch with their diabetologists when on this diet and must be under their supervision and guidance.

9

Monitoring Your Weight Loss/ Maintaining Your New Weight To begin with buy a weighing scale and a measuring tape. Before starting on this diet take your weight and measurements and note them down. Weigh yourself at the same time, preferably on an empty stomach. Retake your measurements every ten days and record them on the chart below (Chart A). Photocopy the chart that has been provided (Chart B) to record what you eat every day and circle in red all the wrong foods that you may have eaten. It will then become clear why you have or have not lost weight. If you are following the diet well and are still not losing weight, it may find that you are overeating due to the presence of too many dishes at a meal. Try eating only one or two items at each meal. Eat slowly and deliberately, chewing well and taking time over each meal. Also make sure that you are maintaining the two or three hour gaps between eating, as recommended.

How Much Weight Can You Lose?

Once you have taken a decision to lose weight, be very strict with yourself. Each time you are tempted to eat something at the wrong time, remind yourself of your goal and what motivated you to lose weight in the first place. It may have been to look better or it may have been to improve your health. Whatever the reason, it was important to you. Your weight will go down rapidly only for the first four months.

The instinct to survive is the strongest instinct in nature. Nature helps all beings to always adapt to their environment and your body will slowly learn to adapt itself to your new diet, so a time will come when you will not lose any more weight. Therefore, be very strict for the first four months.

If you one day feel tempted to eat the wrong food, eat everything wrong on that one day and satisfy yourself completely. Do not do one little wrong every day. You can lose 100 g a day, if you follow this diet

strictly. If you err, then you have lost the chance to lose 200 g since you will not lose fat on that one day and it will take another 24 hours for your fat to start breaking down again to supply glucose to the body.

In the first ten days you will lose from one to three kg of weight. Half of this weight loss is due to the excretion of water from the body. High carbohydrate foods require plenty of water to be present in the small intestine for the absorption of large quantities of glucose. The unattractive protruding abdomen is not all fat. Twenty feet of small intestine filled with water and gas contributes to this unseemly protuberance. On this diet, we lose some of that water from the intestine since we eat less of the high carbohydrate foods and the abdomen immediately goes in. You may even lose two inches around the navel and below the bust in the first ten days. Your stomach will go in very well on this diet. There is no such thing as ‘tummy trimming or tummy tucking’ that can be achieved by machines, vibrators or belts Your tummy will automatically become trim on this diet.

I am often asked whether the ‘skin will sag’ when weight is lost and if any ‘body toning’ is required. When you lose fat from between your skin and the underlying muscle, the fibres that attach the skin to the muscle, automatically draw the skin inwards and the body is naturally restructured so that the skin does not sag. Do not be misled by those who inform you that in addition to losing weight you need special treatments to ‘trim your tummy’ and ‘tone the skin’. However, exercises to strengthen lax abdominal muscles will benefit you so that the intestines don’t bulge forward, adding to abdominal protuberance due to fat deposition. Simple warm up exercises are sufficient to keep your muscles toned and flexible. Remember, no weights, if you want to lose weight.

After the first ten days, you should consistently lose about a kg of fat every ten days and all your measurements will also decrease proportionately. The amount of weight you will lose each month will depend upon how much you ate before you started this diet. If you ate 300 g extra carbohydrate per day, you will lose three kg a month. If you were eating 200 g extra carbohydrate per day, you will lose two kg a month and if you were already diet-conscious and eating only 100 g

of extra carbohydrate every day, you will lose only one kilo every month.

The hips are usually large and appear to decrease at a slower rate.

Your hip measurement will decrease by about 1â&#x20AC;? (2.5 cm) for every 2 kg weight loss. I am often asked whether they should be exercised to help them decrease faster. There is no such thing as spot reduction.

Exercising a certain part of your body will strengthen the muscle, but it makes no difference to the fat over it. This is why machines that electrically exercise a particular muscle (this is known as passive exercise) help to tone up the muscle, but make no difference to the fat over the muscle. Remember, someone who puts you on a machine also puts you on a diet! Losing fat depends on your putting the right food into your mouth. Exercise moderately but consistently; walk briskly for about 20 minutes and do some yoga, which should necessarily include the breathing exercises. All this has nothing to do with your weight loss, but it has everything to do with keeping fit.

I am often asked whether the body’s metabolism slows down when one loses weight. On a natural diet that does not contain excess calories, the body’s metabolism is functioning at its normal rate.

Because the body is not overworking, there is a feeling of health and wellbeing. When the diet becomes unnatural, with an excess of calories, the body has to increase its metabolism to use up those extra calories and all the metabolic processes are speeded up. The body’s organs are overworked resulting in ill health and loss of energy. When, as on this diet, we return to eating naturally, the body no longer needs to overwork itself and maintain an unnaturally high metabolic rate, which consequently returns to normal.

Your weight will continue to go down until your food intake, metabolism and activities reach an equilibrium. This period may vary from six months to one year. You must then focus on maintaining your new weight.

Maintaining Your New Weight A time will come when both your family and friends will start noticing your weight loss and come to know of your new eating habits.

Considering them to be unconventional and strange, they will tell you that since you are now looking good and do not need to lose any more weight, you do not need to ‘diet’ anymore and should therefore return to eating ‘normally’. What they are referring to as ‘normal’ is your old diet that resulted in your weight gain in the first place and which was therefore not the right diet for you. But since you will be hearing this day in and day out, you will start believing what you hear from others and will forget all that you have learnt about choosing the right quality of food. You will initially begin to eat small quantities of high carbohydrate foods at both meals, sometimes even at breakfast, and then you will gradually eat more and more of them, until you are back to your original diet and very sadly, your original weight. Eating high carbohydrate foods is like an addiction, for insulin takes control of your body and hunger is inevitable. So avoid eating more than two fistfuls of high carbohydrate foods and eat them only at night.

Be on your guard and ever watchful of what you eat. Do not make eating a pastime, as is so often the case. Involve yourself in physical or mental activities that give you pleasure so that you do not need to think about food at the wrong time. Once you have reached your ideal or near ideal weight, wear smart tight-fitting clothes and take your weight every day. If you have become careless with your diet you will detect that first one kilo increase in your weight and your clothes will feel uncomfortably tight. Your attention will then be directed to correcting your wrong eating habits.

Do not ever become complacent or satisfied with your new weight.

Let it always be a challenge for you to see whether you can lose just that one more kilo. This way you will be ever watchful, always balancing your protein intake with carbohydrate-rich foods and you will not gain weight. In fact, you may just lose that one last kilo!

Statistics show that 90% of all those who have lost weight, put it back again within a period of five years. Grim statistics indeed. But it has also been shown that losing even 10% of your original weight, or lowering your BMI by 5 points, while perhaps not doing much for your appearance, will do wonders for your health. Lipid profiles and blood pressure levels are improved; in diabetic patients, blood glucose levels are lowered; pain due to osteoarthritis, varicose veins and piles is reduced; polycystic ovaries regress and menstrual cycles are regularised, to mention a few positive effects.

As this system does not forbid you to eat any type of food, you just have to wait for the right time to eat it and you can plan your daily diet based on your individual likes and dislikes. I do hope that fewer people will regain the weight they have so painstakingly lost. It gives me the greatest pleasure to meet someone who had visited me years earlier to lose weight and to see that they have maintained their weight loss.

On the other hand, some of my saddest days have been when I have met those who have regained every kilo they lost and have come back to lose weight all over again.

Information about nutritional requirements and food values is made available to everyone. This information is ignored by most people, for they do not perceive that they have a need to improve their health.

Some people imbibe the information enthusiastically and immediately implement it in their lives, not realising that they must be consistent with their new eating habits and must choose the right quality of food under all circumstances. These people benefit temporarily, since when circumstances become difficult, they slip back into their old eating habits and immediately lose all the health benefits that they might have gained.

Some understand the implications of permanently changing their eating habits and sincerely continue to choose the right quality of food under all circumstances. They do well and are able to maintain their weight loss for quite a long time. But they are surrounded by people who constantly tell them that they do not require to lose any more weight and therefore they do not have to continue with their diet.

These ill-informed â&#x20AC;&#x2DC;well wishersâ&#x20AC;&#x2122; also say that yoga and regular exercise is enough to maintain the new weight and some others will warn that in later years the body will be affected in ways not yet known or understood, if high carbohydrate foods are not eaten at all three meals. Hearing all this advice, and these opinions, these sincere people who did so well, begin to believe what they hear and forget all that they have learnt about eating scientifically. They start eating high carbohydrate foods in large quantities, at all three meals on a regular basis and regain every kilo that they had so happily lost.

And there are others, who understand the information given perfectly. They are ever watchful of their weight and are ever careful about what they eat. If they find that they have gained even one kilo, they are concerned about it and examine what the reason could have been for that one kilo weight gain. They know that glucose from high carbohydrate foods would once again turn into fat or increase their blood glucose levels if they are eaten indiscriminately. They are certain that they do not want this to happen under any circumstances and they maintain their weight loss permanently.

When people notice how nice you look and ask you how you managed to lose so much weight, do not be ashamed to tell them about A New Way to Eat; in fact, it is ‘A Nice Way to Eat!’ If you hide this fact from them and pretend that all it took was a little yoga and exercise, you will have to show them that you are eating all the wrong foods at the wrong times when you are out with them and you will very soon be back to your original weight.

Most diets attempt to lower carbohydrate intake. Everyone’s nature is different from everyone else’s and people would therefore like to choose diets with which they are comfortable. Not only does this diet plan have the advantage of allowing you to eat tasty and nutritious food, but the craving for food disappears—a very important consideration for one who wants to lose weight. Also, on this plan, there is no food that must be completely avoided.

Nobody can give you permanent weight reduction. You can only be given right knowledge which is based on scientific facts. Use this knowledge to help yourself and remember it all your life.

After the age of fifty, an increase of about one kilo every two years is to be expected, since our metabolism slows down as we grow older.

Also, even though we do not deliberately give up normal activities, we are unconsciously doing everything a little slower as the years roll past. So accept the fact that even if you are sincere about your diet, you will be a little heavier as you grow older. Do not ever go back to your old eating habits. You must be stricter with yourself as the days go by. This is contrary to what most people think. It is common to hear people say that they will be very strict with themselves until they lose weight and then they will allow themselves to be a little indulgent later!

Look at yourself in the mirror and value this ‘new you’. Admire your new body and grow to like it, so that you will never want to lose it.

Food in the mouth is a passing pleasure but a well proportioned, healthy body will bring you lasting joy. So it’s up to you. Choose wisely—and all the best!

GLOSSARY TAMIL

ENGLISH

HINDI

CEREALS AND PULSES BENGAL GRAM BLACK GRAM YELLOW GRAM RED GRAM GREEN GRAM Dhal YELLOW GRAM

Kadalai Paruppu Ulutham Parappu Payatham Paruppu Mysore Parappu Pachai Paruppu

Channa Dhal Urad Dhal Moong Dhal Masoor Dhal Kada Hara Moong

Tuvaram Paruppu

Toor / Arhar Dhal

VEGETABLES ASH GOURD (WHITE PUMPKIN) BASIL BITTER GOURD BOTTLE GOURD BRINJAL CABBAGE CELERY STICKS CAPSICUM CUCUMBER CAULIFLOWER CLUSTER BEANS CARROT CHOW CHOW CORIANDER LEAVES CURRY LEAVES DRUM STICKS FENUGREEK FRENCH BEANS FRESH MINT GREEN PEAS

Kalyana Poosanikkai Pushnikai Thulasi Pawakkai Soraikkai Kathirikkai Muttai Kosu Oma Ilai Peri Ghoodhu (Kuda Milagai) Vellirikkai Cauliflower Kothavarangai Carrot Seemai Kathirikai Kothamalli Illai Kariveppilai Murungai Kai Vendhayam Ilai Avaraikkai Poodina Ilai Pattani

Petha Doodhi Tulsi Karela Lawki Baingan Banda Gobi Ajwain Ki Dandi Badi Mirch (Simla Mirch) Kakri Phool Gobi Gowar Ki Pali Gajar Chow Chow Hara Dhania Karipatta Saijan Ki Phalli Methi Pharas Beans/ Balka Hara Poodhina Mattar

GREEN CHILLIES LADIES FINGER LIME MUSHROOM ONIONS RADISH RIDGE GOURD SPINACH SOYA BEAN SPRING ONIONS

Pachai Milagai Vendaikkai Yelumicham Palam Kalan Vengayam Vellai Mullangi Peerkkangai Pasalai Keerai Soya Mochai Vengayathal

Hari Mirch Bhindi Nimbu Khumbh / Dhingri Pyaz Mooli Torai Palak Bhatmas Hare Pyaz

SNAKE GOURD PARSLEY TOMATO

Pudalangai ----Thakkali

Chichonda Ajmoda, Ajmud Tamattar

FRUITS APPLE GUAVA ORANGE PAPAYA POMEGRANATE

Appil Param Koiyyap Pazham Oranju Pappali Pazham Madhulam Pazham

Sabe Amruth / Peru Narangi, Santhara Papitha Anar

CONDIMENTS, NUTS AND OIL SEEDS, ETC ASAFOETIDA ALMONDS ANISEED BAY LEAF BLACK PEPPER CARDAMOM CARAWAY SEEDS

Perungayam Badam Parapu Sombu Punnai Ilai Karapu Milagu Yelakkai -----

Hing Badam Saunf Tej Patta Kali Mirch Elachi Shahjeera

COCONUT CLOVES CINNAMON CUMIN SEEDS CORIANDER SEEDS

Thenganakai Lavangam Patttai Jeeragam Vara Kothamalli

Nariyal Laung Dalchini Jeera Dhania

DRY GINGER FENUGREEK SEEDS FIG GARLIC GINGER MUSTARD SEEDS MANGO POWDER OIL POPPY SEEDS PISTACHIO RED CHILLIES SALT SESAME SEEDS SAFFRON TAMARIND TURMERIC POWDER TYMOL SEEDS

Sukku Vendhayam Athi Pazham Vellai Poondu Ingi Kadugu Mangai Podi Yennai Kasakasa Pistach Kottai Sigappu Milagai Hoopoo Ellu Kungumappoo Puli Manjal Omam

Sonth Methi Bija Anjeer Lasun Adarak Rai Amchoor Powder Teil Khus Khus Pista Lal Mirch Namak Til Kesari Imli Haldi Ajwain

FLESH FOODS EGG FISH CHICKEN

Mootay Meen Kholee

Anda Machhi Murgi

MISCELLANEOUS BUTTER BLACK SALT BUTTERMILK CURD CORN FLOUR COTTAGE CHEESE CREAM CITRIC ACID CURD With VEG DHAL PANCAKE

Vennay Moru Thayiru Makka Chola Mavu Phal katti Paladai, Yeadu ---Thayir Pachadi Aada

Makhan Kala Namak Lassi Dahi Makai Ka Atta Paneer Malai Nimboo Sat Raitha Chilra

SPICES SPROUTS SUGAR MILK VINEGAR WATER YEAST

Masala Moli Kati Chuckarai Phal ---Thannir ----

Garam Masala ---Cheenee Dudh Sirka Pani Khamira

Appendix I FOOD VALUES

Â

Â

Â

Appendix II Medical References that Support this Diet The Potential for Lifestyle Modification and the Inclusion of a Mixture of Unsaturated Vegetable Oils in this Diet 1:1 Following decades of confusion, we now conclude that the type of lifestyle modification that reduces the risk of coronary heart disease, also reduces the risk of Type 2 diabetes. A cornerstone of the advice is the need for saturated fat to be as low as possible and for various vegetables (including legumes and pulses), fruit, whole grain cereals and low fat dairy products to be encouraged. Moderate intakes of fish (some oily) and lean meats are appropriate sources of protein—as are vegetable sources. A mix of unsaturated vegetable oils, including those rich in oleic, linolenic and alpha linolenic fatty acids, are the preferred fat sources, together with some longchain polyunsaturated fatty acids (eicosapentaenoic and docosahexaenoic acids) derived from fish for those who are not vegetarian. To reduce the risk of diabetes, people of all ages should avoid excess weight gain. Weight loss in those who are overweight and obese is an essential co-requisite of advice to change macronutrient composition.

J. I. Mann, “Diet and Risk of Coronary Heart Disease and Type 2 Diabetes”, Lancet 360 (2002): 783–89.

1:2 The ‘Mediterranean Diet’ does not regard all fat as bad. In fact, the focus of the diet is not to limit total fat consumption but to make wise choices. It regards two types of fat – omega 3 fatty acids and monounsaturated fatty acids – healthy and places no restriction on their consumption. Several dietary trials have shown that diets enriched with monounsaturated fatty acids reduce total cholesterol and low density lipoprotein-cholesterol (LDL-C) levels. In addition to improving lipid profiles, olive oil may contribute to cardio protective effects in several other ways, including lowering blood pressure, inhibiting oxidation of LDL-C, providing antithrombotic effects and improving insulin sensitivity. Several studies have shown that, in addition to lowering triglycerides and providing a possible anti-inflammatory effect, omega 3 fatty acids improve parameters of autonomic funtion, including heart rate

variability. Cardiovascular outcomes preventing sudden cardiac death.

are

improved

predominantly

by

Brian M. Curtis, and James H. O’Keefe Jr., “Understanding the Mediterranean Diet”, (CME Credit Article) Post Graduate Medicine 112, no. 2 (2002): 35–44.

1:3 Lifestyle changes and treatment with metformin were both found to reduce the incidence of diabetes in patients at high risk. The lifestyle intervention was more effective than metformin.

William C. Knowler, P. H. Elizabeth Barrett-Connor, Sarah E. Fowler, Richard F.Hamman, John M. Lachin, Elizabeth A. Walker and David N. Nathan (Diabetes Prevention Programme Research Group), “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin”, The New England Journal of Medicine 346, no. 6 (2002): 393–03.

Low Carbohydrate Philosophy Benefits in the Treatment of Obesity, Diabetes and Cardiovascular Disease 2:1 Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome, were found to lose more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet. This was with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost.

Frederick F. Samaha, Nayyar Iqbal, Prakash Seshadri, Kathryn L. Chicano, Denise A. Daily, Joyce McGrory, Terrence Williams, Monica Williams, Edward J. Gracely and Linda Stern, “A Low Carbohydrate as Compared with a Low Fat Diet in Severe Obesity”, The New England Journal of Medicine 348 (2003): 2074–81.

2:2 The increase in high density lipoprotein cholesterol concentrations and the decrease in triglyceride concentrations was found to be greater among subjects on the low carbohydrate diet than among those on the conventional diet.

Gary D. Foster, Holly R. Wyatt, James O. Hill, Brian G. McGuckin, Carrie Brill, B. Selma Mohammed, Philippe O. Szapary, Daniel J. Rader, Joel S. Edman and Samuel Klein, “A Randomized Trial of a Low-Carbohydrate Diet for Obesity”, The New England Journal of Medicine 348 (2003): 2082–90.

2:3 A high protein, low carbohydrate diet with nutritional supplementation, can be useful to reduce several cardiovascular risk factors in obese adult onset diabetic patients, including weight, blood sugar and lipid parameters.

J. S. Edman, “Low Carbohydrate Diet to Reduce Cardiovascular Risk Factors”, Journal of the American College of Nutrition 17 (1998): 1021–27.

2:4 A high-fat, low-carbohydrate diet lowers weight and improves glycemic control and hyperlipidaemia in patients with Type 2 diabetes mellitus.

The Soya Bean Benefits in the Treatment of Obesity, Diabetes, Cardiovascular Disease, Cancer and Menopausal Symptoms 3:1 Dry beans and soya beans are nutrient dense, fibre rich and are highquality sources of protein. Protective and therapeutic effects of both dry beans and soya bean intake have been documented. Studies show that dry bean intake has the potential to decrease serum cholesterol concentrations, improve many aspects of the diabetic state and provide metabolic benefits that aid in weight control. Soya beans are a unique source of the isoflavones – genistein and diadzein, which have numerous biological functions.

Soybeans and soyfoods potentially have multifaceted health promoting effects, including cholesterol reduction, improved vascular health, preserved bone mineral density and reduction of menopausal symptoms. Soy appears to have salutary effects on the renal function as well, although these effects are not well understood. Whereas populations consuming high intakes of soya have lower prevalences of certain cancers, definitive experimental data are insufficient to clarify a protective role for soy. The availability of legume products and resources is increasing; incorporating dry beans and soy foods into the diet can be practical and enjoyable. With a shift towards a more plantbased diet, dry beans and soy will be potent tools in the treatment and prevention of chronic disease.

James W. Anderson, Belinda M. Smith, and Carla S. Washnock, “Cardiovascular and Renal Benefits of Dry Bean and Soya Intake”, American Journal of Clinical Nutrition 70 (suppl) (1999): 464S–74S. 3:2 Emerging evidence suggests that diets rich in phytoestrogens (isoflavones and lignans), namely soy protein and flaxseed can have beneficial effects on many aspects of diabetes and obesity. The beneficial effects of dietary soy and flaxseed are observed in both healthy and

experimental animals and in healthy humans and those who are obese or have diabetes mellitus. The dietary components responsible for the beneficial effects of soy protein and flaxseed in diabetes and obesity have yet to be determined. However, the studies described above indicate that the beneficial effects may be due to phytoestrogens (isoflavones and lignans), saponins and the trypsin inhibitor in soybean; the nature and amount of fibre consumed; the nature of the protein and protein hydrolysate consumed; the amino acid composition of the protein consumed and the fatty acid composition of soy and flaxseed oil. In obesity and diabetes, one or more components may have a beneficial effect singly, synergistically or additively with other active components.

Sam J. Bhathena and Manuel T. Velasquez, “Beneficial Role of Dietary Phytoestrogens in Obesity and Diabetes” American Journal of Clinical Nutrition 76 (2002): 1191–01.

3:3 Studies show that dietary supplementation with soy phytoestrogens favourably alters insulin resistance, glycemic control and serum lipoproteins in postmenopausal women with Type 2 diabetes, thereby improving their cardiovascular risk profile.

Vijay Jayagopal, Paula Albertazzi, Eric S. Kilpatrick, Elaine M. Howarth, Paul E. Jennings, David A. Hepburn and Stephen L. Atkin, “Beneficial Effects of Soy Phytoestrogen Intake in Postmenopausal Women with Type 2 Diabetes”, Diabetes Care 25, no. 10 (2002): 1709–14.

3:4 Studies also suggest that an isoflavone 100 mg regime treatment may be a safe and effective alternative therapy for menopausal symptoms and may offer benefits to the cardiovascular system.

Kyung K. Han, Jose M. Scares, Jr., Mauro A. Haidar, Geraldo Rodrigues de Lima and Edmund C. Baracat, “Benefits of Soy Isoflavone Therapeutic Regime on Menopausal Symptoms”, The American College of Obstetricians and Gynecologists 99, no. 3 (2002): 389–94.

3:5 Plant stanols are derived from natural sources, such as soybean and corn. Stanols function by blocking absorption of dietary and biliary cholesterol in the intestine. Taking the recommended dose of three servings per day, patients who use plant stanols may experience a drop in total cholesterol levels of between 10% and 12% and an LDL-C reduction of between 14% and 17%.

Brian L. Pearlman, “The New Cholesterol Guidelines: Applying Them in Clinical Practice”, 112, no. 2 (August 2002): 20.

3:6 Regular intake of soya foods is associated with a reduced risk of endometrial cancer.

Wang Hong Xu, Wei Zheng, Yong Bing Xiang, Zhi Xian Ruan, Jia Rong Cheng, Qi Dai, Yu Tang Gao, and Xiao Ou Shu, “Soya Food Intake and Risk of Endometrial Cancer among Chinese Women in Shanghai: Population Based Case-Control Study”, British Medical Journal, 10 May 2004 doi:10.1136/bmj.38093 646215.AE. 3:7 A large prospective cohort study found that soy food consumption was significantly and inversely associated with the risk of CHD among Chinese women. The study provides the strongest argument to date for the recommendation made by the American Heart Association to increase soy food intake to promote heart health.

Xiangian Zhang, Xiao Ou Shu, Yu-Tang Gao, Gong Yang, Qi Li, Hongian Li, Fan Jin and Wei Zheng, “Soy Food Consumption is Associated with Lower Risk of Coronary Heart Disease in Chinese Women”, The American Society for Nutritional Sciences 26 June 2003; 0022-3166/03:2878.

Health Implications of Obesity 4:1 Obesity is no longer just an American problem. The UK House of Commons Health Committee issued its report on obesity on 27 May 2004, predicting that obesity would soon overtake smoking as the leading health problem in the United Kingdom. Throughout Europe, obesity has increased 10 to 50% within the past decade and as much as 75% in parts of the developing world. Worldwide over a billion adults and children are overweight, and some experts have predicted that children of the current generation are likely to have shorter life expectancies than their parents, because of obesity.

Anjali Jain, “Fighting Obesity”, British Medical Journal 328 (2004): 1327.

4:2 Reduced intake of saturated fatty acids and other lifestyle interventions aimed at lowering rates of obesity are the changes most likely to reduce the epidemic numbers of people with Type 2 diabetes and coronary heart disease (CHD).

J. I. Mann, “Diet and Risk of Coronary Heart Disease and Type 2 Diabetes”, Lancet 360 (2002): 783–89.

4:3 A measurement of degree of excess weight and obesity indicates that there is suggestive evidence that decreases in abdominal fat will improve glucose tolerance in overweight individuals with impaired glucose tolerance and there is limited evidence that increased cardio-respiratory fitness also improves glucose tolerance in overweight individuals.

The National Heart, Lung and Blood Institute (1999) Executive Summary of Clinical Guidelines, on the Identification, Evaluation and Treatment of Overweight and Obese Persons with Type 2 Diabetes.

4:4 Although BMI and physical activity are independent predictors of incident diabetes, some studies found the magnitude of the association with BMI than with physical activity in combined analyses. These findings underscore the critical importance of adiposity as a determinant of diabetes.

Amy R. Weinstein, Howard D. Sesso, I. Min Lee, Nancy R. Cook, Joann E. Manson, Julie E. Buring, and J. Michael Gaziano, “Relationship of Physical Activity vs Body Mass Index with Type 2 Diabetes in Women” Journal of the American Medical Association 292, no. 10 (2004): 1188.

4:5 The medical community needs to lead in communicating the importance of physical activity for health and weight maintenance. Just as weight is addressed in some manner at nearly every physician visit, so should attention be given to recommending the accumulation of 30 minutes a day of moderate intensity physical activity at least 5 days of the week. This can be obtained through brisk walking, bicycling, swimming, or activities of daily life such as housework or gardening.

Steven N. Blair, and Tim S. Church, “The Fitness, Obesity, and Health Equation – Is Physical Activity the Common Denominator?”, Journal of the American Medical Association 292, no. 10 (2004): 1233.

Result of Excess Carbohydrate Intake Effects of Diabetes and Cardiovascular Disease 5:1 Many patients who have normal LDL-C levels are at substantial risk of coronary artery disease (CAD). These patients include those with diabetes or insulin resistance who tend to have high levels of triglycerides and low levels of HDL-C (high density lipoprotein-cholesterol). Numerous studies have confirmed that low-fat, high-carbohydrate diets (e.g. the AHA diet) tends to raise triglycerides and lower HDL-C levels.

Brian M. Curtis, and James H. O’Keefe Jr., “Understanding the Mediterranean Diet”, (CME Credit Article) Post Graduate Medicine 112, no. 2 (2002): 35–

44.

METABOLISM There is evidence that suggests that different food sources have different effects on metabolic processes and fat deposition. OSCAI (1982) Dietary Induced Severe Obesity : A rat model : American Journal of Physiology. 242 : 212 ‐ 215 The types of food consumed have more impact on obesity than the quantity of the food consumed. EMERY et al (1993) A review of the association between abdominal fat distribution, health, outcome measures and modifiable rich factors. American Journal of Health Promotion. 7 (4) : 342 – 351.

HELENIAK et al. (1989) Prostaglandin, brown fat and weight loss. Medical hypothesis. 28 : 13 – 33 Change in the composition of an individuals diet can have a profound influence on substrate oxidation in the absence of any change in total energy expenditure. JEBB (1997) Aetiology of obesity. British Medical Bulletin. 53 : 264 ‐ 285 PHYSICAL ACTIVITY Physical activity may represent 20 to 50% of total energy expenditure of a given individual. PRENTICE et al (1996) Energy expenditure in affluent societies : an analysis of 319 doubly‐labeled water measurements. European Journal of Clinical Nutrition. 50 : 93 – 7 To make matters worse, physical activity in childhood and adolescence appears to be on the decline. CENTERS FOR DISEASE CONTROL AND PREVENTION (1996) Physical Activity and Health: a report of the surgeon general: Atlanta: National Center for Chronic disease prevention and Health Promotion : United States Department of Health and Human Services.

An alarming increase in obesity in children and adolescence can be explained partly by these changes in society and culture. This obesity is usually carried into adulthood. TROIANO et al. (1995) Overweight prevalence and trends for children and adolescents : the national health and Nutrition examination surveys, 1963-1991. Archives of Pediatrics. 149 : 1085 – 91

INSULIN IMBALANCE Many causes of obesity can be due to an imbalance of the hormone insulin.

Insulin allows the body to utilize glucose. Factors such as genetic predisposition, food allergies, eating habits and stress may interfere with glucose utilization resulting in “glucose intolerance”. STROHECKER (1994) Alternate medicine – the definitive guide. Future medicine publishing, Inc Chronically elevated glucose levels due to inefficient insulin action could cause someone to overeat. Carbohydrates in the obese trigger release of excessive insulin that the body cannot use. Insulin receptor cells are blocked thus preventing the transfer of glucose to the cells, resulting in the conversion of glucose to fat. NANCY (1996) Theories of Obesity. Chatham college: Pittsburg, PA The relationship between obesity and increased risks of morbidity and mortality is well established. Obesity profoundly affects the quality of life.

FONTAINE et al (1996) Health‐related Quality of life in obese persons seeking treatment. J Fam Pract. 43 (3) : 265 ‐ 270 About one in every three persons is at least 20% above ideal body weight and app. 5% have direct weight related serious health problems including hypertension, hyperlipidemia, coronary heart disease, adult onset diabetes mellitus, degenerative osteoarthropathy and obstructive sleep apnea.

BALSIGER et al (1997) Surgical treatment of obesity : Who is an appropriate candidate? Mayoclin Proc. 72 (6) : 551 ‐ 557 However, a 5 to 10% weight reduction in obese patients is associated with significant health benefits. CERULLI et al (1998) Outcomes of

Pharmacological and Surgical treatment for obesity. Pharmacoeconomics. 14 (3) : 269 ‐ 283

SOYA SOURCES Soya Flour, Soya Wheat Flower and Soya Roasted Nuts are manufactured by: S.V.S. Agencies Chennai 600097 Phone: 044‐24963219 E‐mail: svsagencies@gmail.com

DOCTORS COMMENTS Obesity is essentially due to ones calorie and carbohydrate intake being in excess of an individual's requirement; caused by overeating and insufficient exercise. The impact of TV viewing and computers, coupled with odd school timings and the eating of junk food, have contributed to this preventable morbidity. Hence it is very important to focus on this issue of obesity right from childhood. This book is a boon for all parents who care for their kids; a must for every Indian home - Dr. Viswanath J. M.D. (Ped ) D.C.H; F.R.S.H. ( Lond ) Consultant Pediatrician Chennai.

I have been closely associated with Dr Tusna Park in treating obese, infertile PCOD patients. In the present day scenario obesity is an important and often overlooked cause of infertility, more so when associated with PCOD. Hence the relevance of this book increases significantly. I congratulate Dr Tusna Park for bringing out this book, which will be very useful for all of us.

- Dr Nirmala Jayashankar M.R.C.O.G. ( Lond ); M.D.; DGO; Consultant Obstetrician and Gynecologist Apollo Hospitals Chennai.

I have no doubt at all that the use of the principles outlined by Dr Tusna Park would be very effective in achieving significant weight reduction. Reduction of weight, incidentally would have tremendous benefit for the prevention of diabetes, correction of hyperlipidaema (serum cholesterol and triglyceride levels), controlling hypertension (high blood pressure) and prevention of coronary artery disease.

- Prof.V. Mohan M.D.; M.N.A.M.S.; Ph.D.;D.Sc. Diabetologist and Managing Director M.V. Diabetes Specialities Center (P) Ltd, Chennai.

Dr Tusna Park who graduated from CMC Vellore ( India ) in 1975 has been practicing in Chennai since 1991. She has helped hundreds of people to lose weight,improve lipid profiles and achieve better glycemic control with her diet which is scientifically balanced and easy to follow. How wonderful to be able to eat and lose weight !

- Dr Su Thillai Vallal M.D. (Int. Med.) D.H. (Cardiology) Managing Director Venkateshwara Hospital, Chennai.

PATIENTS COMMENTS I have been a diabetic since 1986 and have been on 20 units of insulin and oral hypoglycemic drugs, in spite of which the fasting blood glucose level remained high at about 260 mg/dl. I now have a clear understanding about why I could not control my elevated blood glucose level and have consequently changed the way I eat. Today I am on no insulin but do continue to take medicines. My fasting blood glucose levels have stabilized at about 130 mg/dl.

- Mrs Devika Rani 61 year old Housewife. Chennai. India

I suffered from the effects of hormonal imbalances due to Polycystic Ovarian Disease which is usually associated with obesity. Since losing weight, the cysts have regresed and hormonal imbalances have been restored to normal. I have learnt to eat without fear! I wish that I had this knowledge when I was younger so that I could have avoided these complications.

- Mrs Abhirami 29 year old Housewife Chennai India

I am nine years old and felt terrible last year because I was so fat and couldn't wear nice clothes. Today I feel so happy and smart. I have lost 10 kilos in spite of being able to eat all my favourite foods, but at the right time and in the right combination. My mother has lost weight as well.

- Miss Karthika 9 year old Student Chennai India

I wouldn't have imagined that I could lose 20 kilos without exercising vigorously ! It has been wonderful to be able to eat and lose weight.

- Miss Lavanya 26 year old Teacher Chennai India

I never thought that it would be possible to be introduced to an intellectual approach to eating! I have benefitted tremendously from this experience, since it has made my life more positive.

- Mrs Amrita 60 year old Artist Chennai India

BACK COVER Weight reduction is often the first line of treatment in most medical conditions. Indians especially need to change the way they eat if they are to tackle their increasing susceptibility to conditions such as obesity, diabetes and cardiovascular disease. This book provides a complete health plan which is practical and easy to follow. It has been researched by a diabetologist, cardiologist and dietician and combines some of the most recent findings in medical studies with a scientific conception of a healthy diet. The book makes for intelligent and enjoyable reading and is a must for every home!

Tusna Park has an M.B.B.S. from The Christian Medical College in Vellore. She has been practicing in Chennai since 1991 and has helped a number of people to lose weight and then maintain their weight loss with personalized consultations and follow up. Many people who have adult onset diabetes have achieved better glycemic control on her diet plan, which she emphasizes, must be followed for the rest of their lives.

Dr. Tusna Park's novel ideas on food, presented in this book, make interesting reading. Her diet plan, while unconventional in terms of dietetics, works for her clients. Being a medical doctor, she aims at treating obesity and normalizing insulin resistance, which is of prime importance for those battling the Metabolic Syndrome.

Nirmala Jesudason, PhD, RD (ADA & DC) Consultant - Food & Nutrition Services Frontier Lifeline Hospital Chennai - 600 101, Tamil Nadu, India.