What role does the Indian cuisine play in the EAT-Lancet Reference cuisine?

There is a lot of interest in identifying and evaluating diets that can help you stay healthy while not harming the environment. The EAT-Lancet Commission issued suggestions on healthy food patterns that may sustain 10 billion people in an environmentally sustainable way by 2050 in 2019.

Based on this, a group of experts from India’s International Food Policy Research Institute examined how well the Indian food consumption pattern corresponds to this reference diet in 2020. According to the study, which was published in the journal BMC, the majority of India is still malnourished due to a lack of protein, fruits, and vegetables.

An improper eating pattern is inextricably related to poor nutrition and chronic illnesses and is a key risk factor for noncommunicable diseases (NCD), combined with a lack of appropriate physical activity. increasing consumption of lipids, particularly of animal origin; insufficient intake of fruits and vegetables; high salt consumption; and increasing intake of highly processed foods are all indicators of poor diet quality.

India is plagued by communicable and noncommunicable illnesses. From 1990 to 2016, heart disease was reported to be the leading cause of death among illnesses. This is usually caused by overnutrition or overeating.

Meanwhile, dietary iron deficiency was the leading risk factor for impairment. This is usually caused by malnutrition. As a result, these situations constitute a syndemic, representing India’s existence of both excessive and insufficient food intake.

Diet Plan EAT-Lancet
It is essential to safeguard the environment when producing food for human use. The EAT-Lancet reference diet specifies a diet for children as young as two years old. Overall, it is made up of plant-based foods that contribute carbs, proteins, unsaturated oils, vitamins, and minerals.

Fish and other shellfish, as well as poultry, are available in moderate proportions, while meat (red or processed) is either absent or present in modest amounts. Sugar, white flour, and starchy vegetables are all prohibited. This diet just lays out a pattern, taking into account the differing demands of the sexes, different phases of growth and development, pregnancy, sickness, or increased physical activity.

The main difference between the EAT-Lancet reference diet and other RDAs published by other professional groups is that it takes into consideration the ecological footprint of the items included. However, this component of Indian cuisine is not addressed in the current article.

The study relied on data from the Consumption Expenditure Survey (CES). This is a countrywide survey conducted in 2011-12 by the Countrywide Sample Survey Organization (NSSO) of a representative sample of rural and urban households.

The study included almost 7,500 rural and over 5,000 urban households, providing India with the most latest representative statistics available. The scientists calculated the daily calories from each food group using NSSO food consumption data.

To prepare staple dishes and snacks, Indians use refined flour or white flour, semolina, rice and wheat flour, and other processed cereals. The oils used in the NSSO’s CES survey differ slightly from the categorization used by the EAT-Lancet group in that Indians utilize both saturated and unsaturated oils, either together or separately.

They also enjoy sweet liquids such as tea, coffee, and other beverages, as well as chips and chocolates. Spices contribute 1-2% of total calories in the Indian diet but are not included in the EAT-Lancet reference diet.

What did the study reveal?
Even as India asserts its place as a global power, NSSO data from a little more than a decade ago shows that mean daily food consumption for 95% of the population remains below the recommended amount of 2,500 kcal/day. Only the top 5% of income earners have daily intakes that meet or surpass these thresholds.

People in the top deciles of monthly per capita consumption expenditure (MPCE) consumed almost one-fifth more calories per day than the reference diet, at around 3,000 kcal/day. This is double the amount consumed by people in the lowest deciles, who consume around 1,600 kcal per day.

Surprisingly, this coexists with growing obesity rates, most likely due to the fact that more than half of Indians, particularly ladies and city dwellers, are not physically active.

Calories derived from cereal
In comparison to the EAT-Lancet reference diet, the average Indian consumes more calories from whole grains but less from fruits and vegetables, legumes, and animal-derived foods including meat, fish, and eggs.

Whole grains are the most often eaten food. Furthermore, the consumption of dairy and dairy-based foods, starchy vegetables, and palm oil exceed the limits suggested in the reference diet.

At equivalent MCPE, Indians follow the same food habits in rural and urban environments. Indian households that spend the least on food, that is, those in the bottom tenth of food spending, rely heavily on whole grains, starches, and processed meals, with nothing else. This pattern is repeated throughout the rural-urban split.

Protein deficient
Protein accounts for just 6-8% of calorie consumption, compared to 30% in the reference diet. This deficit is visible throughout India, regardless of income, but it is more pronounced in rural regions, where protein accounts for only 6% of total calories. Consumed protein calories in the top 5% still amount to less than half of the required protein intake in the reference diet.

Legume consumption is lowest in North-eastern India. Lentil output has progressively fallen during the previous half-century.

Calories from fruits and vegetables are limited.
In the reference diet, fruits and vegetables account for around 8% of daily calories. Surprisingly, only Indians with the highest incomes fulfill the standards for fruit and vegetable consumption. Nonetheless, the wealthy consume more of these foods and fats than the poor.

Fats, fruits, and other sources of calories
Fat-based calories in the Indian diet are also lower than in the reference diet, despite a 3-5% increase in fat consumption between 1993-94 and 2011-12. Saturated fats account for a greater proportion of total fat consumption, notably palm oil, which is the main component of vanaspati, or partly hydrogenated vegetable oil.

Vanaspati is widely used in residential, restaurant, street, and commercial food preparation, with its use increasing by more than 50% between 1993-1994 and 2011-12. Vanaspati is most often used in western Indian states.

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Fruit consumption accounts for less than half of the reference diet on average, whereas vegetable consumption falls short by a smaller percentage.

Processed meals are becoming more popular, particularly among wealthier city dwellers. On average, processed foods contain more calories than fruits, accounting for 10% of total caloric consumption, whether rural or urban.

The richest city people consume nearly a third of their calories from processed foods, compared to 13% of the richest rural Indians. Even among the poorest, these foods provide 8% of calories for both urban and rural inhabitants.

Processed foods account for 13% of consumption in South India, compared to 8% in the northeast and North India.

Except in South India and the Northeast, animal protein accounts for 6% of total calorie consumption in the reference diet but is low in the average Indian diet. Red meat consumption is often low.

What are the consequences?
When compared to the EAT-Lancet reference diet, the average Indian diet is unhealthy. Indians rely on cereals, generally whole grains, to satisfy their calorie demands but fall short on protein, vegetables, and fruits.

Animal protein intake in India is startlingly low. As a result, overconsumption of animal flesh or products is not a problem in India. Even if up to 80% of Indians now identify as non-vegetarian, the “majority of non-vegetarians report that they consume meat only occasionally.”

The biggest problem with the reference diet is its high cost, which is 1.5 times more than the lowest nutritionally appropriate diet. Fruits, vegetables, and animal products are the most costly food components in the world. In India, the cost of nutritious meals is growing faster than the cost of fats and veggies.

In South Asia, the reference diet would account for more than 60% of average family income per capita per day. With wheat and rice subsidized through Public Distribution Systems and low market pricing for these grains owing to market control, Indians naturally rely on cereals for their primary calorie intake.

Even the wealthiest people fail to satisfy reference diet requirements, favoring processed meals and cereals over protein and fruits and vegetables. “This points to a lack of availability, accessibility, awareness, and acceptability as additional major causes of poor diet quality.”

In fact, the CES survey understates food intake by not accounting for out-of-home meals or processed foods. However, the National Food Security Act (NFSA)-2013 authorized the distribution of wheat and rice at reduced rates to the poorest two-thirds of the Indian population.

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This increases reliance on grains. To counteract this measures favoring the cultivation of healthful foods rather than rice, wheat, and sugarcane, as well as making the former more affordable, are required. Subsidies for healthy foods should be the norm, and public awareness programs should be launched to assist people to realize why they should consume more of these foods instead of rice and wheat.

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