 Hello friends, Nishan here. Welcome to the fifth episode of Manipal Hospitals, fifth episode of Health Wives for Manipal Hospitals. Health Wives is a unique show where you get to ask questions related to health with the leading doctors of Manipal Hospital. So, my friends, today the topic is something which everybody is concerned of. It is said that diet is like a bank and the good food what we eat is like a good investment what we do. If you see the data, if you see the stats, it is said that among the individuals about 20 years of age 33.3% are overweight, 35% are obese and 5% are extremely obese. The poor food eating habits and lack of physical activities are the major contributors for various diseases related to diet and nutrition. So, to answer to all these questions we have with us Dr. Kavita Simham who is HOD of Diet and Nutrition Department. So, welcome ma'am. Thank you. So, we have lots of questions lined up for today's show related to diet and nutrition. So, without wasting lots of time I would go to the first question. The first question is from Mudit. What are the most common nutritious food in a veg and non-veg diet that one can follow? Actually, there are many things. I believe the bottom line is that whatever is natural and fresh and has been passed on to us from generations is always healthy over what is available off the shelf or processed. You know, something that you conveniently buy off the shelves may not be healthy. So, the bottom line and very easy to remember is that if you want healthy food, cook it at home. So, that is the best advice in both vegetarian and non-vegetarian. Ma'am, according to you what is the exact definition of healthy lifestyle and healthy food? A healthy lifestyle is something that enables you to be healthy, enables you to carry out your day-to-day activities, enables you to also have a lot of energy in excess that you know that you would require for stressful situations and also to ward off lifestyle diseases, chronic lifestyle diseases as in diabetes or obesity or heart disease or whatever. So, a healthy lifestyle needs to take care of all these things. At the same time, you also asked me about a healthy diet. A healthy diet is something that includes all the major food groups in the right balanced way and is fresh and is locally grown and is also prepared at home. So, that is what my take on healthy diet is. So, the next question is from Rohit. What foods are high in protein? If you are talking about non-vegetarian foods, you have the dairy products which are really good sources of protein and you also have eggs and of course fish and chicken are always good sources but then we do not always recommend eating red meat as it is associated with a lot of other risk factors as in cancer, risk and other things. But when you are talking about vegetarian proteins, legumes and pulses are the best sources as you know and of course whole grain cereals are also good sources of protein, of course not to forget nuts. Nuts are a great source of protein as well. Ma'am, what is your take on protein shakes? Because now it is a young India, so most of the people run to gyms so they can reduce their weight and make good body like retic erosion, 6 packs. So, they get into buying more of supplements that is protein shakes. So, what is your take on protein shakes? That is a very good question actually and very relevant today because everybody wants a quick fix, everybody wants to take something off the shelf which does not require much time to prepare but then you need to be aware of the dangers of taking high protein supplements without the proper doctors or dieticians advice because it could be harmful in the long run and you never know what kind of ingredients are added to these proteins. Sometimes steroids are mixed and sometimes you never know what kind of artificial sweeteners and preservatives are also added. Does it affect the bones ma'am? I have heard it like more intake of protein will always lead to some damages caused to the bones joints. I don't think there is any correlation with protein intake and bone damage as such but then high protein is a risk factor for developing kidney disorders as in and could also lead to dehydration in the long run because excess protein kind of dehydrates and that also puts the stress on kidneys by maximizing the dehydration. So, you suggest whenever you take any kind of protein supplements it is always to take suggestion from a physician. Yes, absolutely. A prescription is necessary. A prescription of possibly a good brand which has been tried and tested and it's clinically, you know, trials have been done on this product and have been proven to be safe and this should necessarily be backed by medical professionals prescription. So, that should fit into a healthy balanced diet plan as well. So, supplements are any day not advised. Next question is from Nirmal. What are good and bad carbs? Well, good carbs are generally something that is complex and is fiber rich when you retain the entire husk of grains and legumes you are getting the maximum amount of fiber which has many health benefits and so we call them good carbs. So, bad carbs are something that don't do anything that is just empty calories and don't have anything any other nutrients apart from just starch. So, those will include anything white and refined in vegetarian products as in via the rice flour and white bread anything white and vegetarian will be just empty calories and then bad for it. Even rice? Even white rice, not necessarily all kinds of rice but yeah, white rice is generally just starch. I mean speaking of rice I just remember one thing is brown rice better than white rice or boiled rice what we eat? Definitely, brown rice because it tends to have more of the outer husks still intact that is if it's unpolished. If it's highly refined brown rice it's the same as white and if it's steamed or power boiled it tends to retain more of the nutrients because when they do the power boiling process the entire outer husk nutrients enter the rice grain so thereby you are getting more of the nutrients. So, power boiled or steamed rice is better and at the same time unpolished brown is always better than white. So, the next question is from John what is the meaning of good fat and bad fat and which food comes in which category? So, basically you want to know which food comes in which category? What is good fat and what is bad fat? I think that's a pretty long list to cover in this forum but then I can just briefly tell what is good and what is bad. Good fats are something that are essential I mean there are all kinds of fats some are generally manufactured in the body itself so we call them non-essential fats but these are manufactured from the fats that we supply in the diet which are essential. So, then essential fats are necessary to produce non-essential fatty acids so there are all kinds of fats and then we have three major categories which we call PUFA, MUFA and SFA PUFA is polyunsaturated fats MUFA is monounsaturates and then finally we have saturated fats all three are necessary although there is no recommendation for saturated fats as such and they are associated with the coronary artery disease they may lead to blockage of arteries so apart from SFA, the other two that I mentioned are necessary part of your diet and they are healthy, they are good fats. When we eat we never think about so much of science is involved in this starch, carbohydrates. So, I guess John must have got his answer for this question that is good fat and bad fat. So, next question is from Abhinav what is the ideal distribution in once meal of carbs protein, vitamins, minerals and more? What he is trying to ask is what is the intake of protein, vitamins and minerals and more? I think he wants to know what is the recommendation levels what amount of protein is required in a day? So, when it comes to macronutrients we are basically what we follow is the guidelines set by the ICMR or Indian Council of Medical Research so they have set guidelines for Indians to follow and you know an adult sedentary man for example needs around 2,000, 2,400 calories in a day provided is active and a woman, adult sedentary woman needs between 1,800 to 2,000 again provided she is active. Now, when it comes to distribution of carbs, protein and other macronutrients there is a ratio fixed rather than you know giving an exact number in terms of grams so it is all based on how much calories you are getting. If you are getting a 2,000 calorie diet 50 to 60 percent of it should come from carbohydrates 15 percent will come from proteins rest will come from fats which is a maximum of 30 percent so that ratio is not you know absolute it is relative and it needs to be you know correlated with the energy intake so that is as a major vitamins and all it is too long it is too long to cover in this forum but then if you are getting maximum amount of carbs and proteins in the right balance you are also getting most of your meals. So, you know for more information you will have to come to Manipal hospital as well. Definitely. So, next question is from Rohit if a high sugar diet is bad for health then how can it be healthy to eat lot of fruits every day has it contains natural sugar? Good question actually but I don't know what is the level of fruit intake here being defined lot of fruits can be many things to many people you know some people think eating even one fruit is lots and some people think the entire days intake should come only from fruits so the level of intake also needs to be defined but then there is a recommendation which says you should get at least one serving of fruit in a day that is up to you know about 100 grams to 200 grams of fruit per day is recommended and that is not lost and if you are going to exceed that in any amount it is going to be harmful in the long run because you are replacing other nutrients from other food groups ideally we should get all our nutrients from a variety of food groups rather than sticking to one food source so that is the only concern it's not sugar as in you know it's not going to be harmful to that level we are getting too much of simple sugars because fruits ultimately are full of fiber and there are other nutrients as in vitamin C and citrus and there are antioxidants and there are many other things as well so I wouldn't classify fruits as just simple sources of sugar so intake of more fruits will lead to increases of fiber well again we have to define what is more here and if you are sticking to the guidelines and maybe marginally overdoing this it's still safe so the next question is from Bael I often miss eating my breakfast is this the reason for my gastric problem could be because you know long periods of fasting generally tends to increase acid production and then if you are not eating anything in the morning you can quench that acidity quench that acid production it may just worsen throughout the day and of course the rest of the foods that you eat during the day also matters I mean if it's very acidic and then high in fat and in oils that also may step up your acid production ma'am at this I remembered one question actually they say when you have a breakfast have like a king is there any correlation or connection for this like is it necessary that you should have a heavy breakfast and a little bit of mild lunch and after that just two biscuits or just fruits diet like a popper you know that used to be a concept and it's promoted widely it's promoted worldwide that's the reason worldwide I know but then as far as evidence goes it's not backed by evidence it's not backed by evidence what we actually have is distribute your carbs and proteins throughout the day in equal amounts which means that all meals should be balanced as long as you know you're not exceeding in any meal and not you know being very deficient in any meal it should be good this kind of advice is not practical also I mean children now you know they have to rush to school and you all have buses and trains and whatever to catch and we won't have time to eat like a king an elaborate breakfast most of us don't I mean that's the reality understood especially in Bangalore I have seen the other breakfast in their vehicles rickshaw or cabs so the suggestion is not to skip breakfast not to skip breakfast whatever small thing it is it could just be boiled egg and a glass of milk or just a few words even a fruit it's still important to have that so Payal's suggestion for you from Kavita Mam is don't skip your breakfast have at least a fruit have at least one boiled egg glass of milk would be fine so next question is from Reshna how many times should we eat in a day is it true eating six times a day is good for losing weight that I think I already kind of partially answered in my previous but yeah there is no fixed amount of tanks that you need to eat during a day to be healthy it depends on your lifestyle it depends on the practicality of everything and if three meals are what you can get by all means get the three meals then it should be balanced it should include as many food groups as possible and it should meet your own nutrient needs as long as you're doing that three meals are also good and that is the way we've traditionally been eating the six meal a day is a recent concept and many people are under stress to try and meet those six meals which is not happening some always carry a packet of biscuits in the box so that they keep eating once in an hour what you eat during those six meals is more important than just getting six meals a day then we have a question from Aparna does eating rice twice a day affect our health in any way no not at all, rice is not a villain it need not be banned and it need not be blamed for everything we have on earth I guess we need to put in the quantity this quantity of anything will matter whether it's rice or chapatis or ragi they're all serious and they all have equal amounts of carbs or energy or whatever so whatever you eat quantity is important and rice per se is not bad as long as you balance it with other vegetables and grains and everything should be balanced it's not harmful but then again as we said already it should come from complex carbohydrates it should be unbalanced so this is the question which I wanted to ask thank you Ritika for this question are complexes and chokos healthy for breakfast I'll add even oats oats is it good for breakfast, healthy breakfast? it is ideally better you cook something fresh from locally grown ingredients and something that you can freshly take off the stove any is always healthier than something that is processed and off the shelf because anything processed will have chemicals additives and sugar some kind of preservatives it always has to have preservatives so ideally it's not a good situation unless you don't have any options and then you might have to buy something that is whole grain and sugar free if possible but then for those who can cook at home this is not an ideal option the next question is from Aravind how much chocolate cheese can I eat in a day and not to gain weight this is some kind of secret if you just cover it you can let us know but then there is no sense see the entire day's calorie intake will matter not from any particular food alone so the entire meal has to be calculated and planned out and it's better you consult a professional to see how the chocolate can be fit into your day's intake it's not necessarily to be avoided but then you have to see count the total calories and so on there is one such interesting question from Simran I often bring alcohol after having my dinner is it a very bad habit brushing teeth after dinner is a good habit but I don't know about that alcohol, yeah of course now the recommendations are there that we need to minimize alcohol intake as much as possible and especially the men so ladies need to be more cautious about alcohol intake because it affects them in different ways it might mess up with their productive system the menstrual cycle as well not to mention the high amount of sugars and alcohol per se so leading to weight gain and all that so it's better cut down and minimize minimize as much as possible so Simran it's a bad habit it's not a good habit it's a bad habit so it's better try to reduce it lesser the amount of alcohol so the next question is from Sneha I am a 23 year old vegetarian with a skinny body I want to put on some weight to look better and more presentable what is the most healthy way to achieve this for a strict vegetarian for a strict vegetarian I think if you've not mentioned if you do take dairy products that will be the best source of protein if you do and if you're not allergic to dairy products this includes plenty of milk curds and paneer made out of cow's milk as far as possible in your daily diet and nuts are a great source of energy and protein not to mention all kinds of other micronutrients so a lot of handful of nuts I know that includes ground nuts and almonds and walnuts all are healthy so you can step up on that and of course fruits are always a powerhouse of nutrition so you can add them as well not to mention the whole grains and seeds which are always part of healthy diet so the next question is from Deeksha what are the benefits of eating eggs what nutrition does it provide the eggs are great sources of protein it's the best biologically available protein that we have we grade the protein quality in different terms and the egg matches the highest level everything else is measured in terms of the quality of egg so it sets the benchmark as far as protein is concerned other than protein you also have various fat soluble vitamins as in vitamin A in the yolk there is also some modified there is biotin, there is riboflavin there are many of other nutrients there is a long list actually and it's all healthy so it is good I am sure all the viewers will be having this doubt is eating yellow yolk is it good for health like more eating of yellow is it good for health or bad again we are guided by the recommendations there is no such thing as more there is no such thing as less everything is in a moderation and in a balanced way nothing is harmful I mean egg is a natural source of protein as well so if you are getting three whole eggs in a week that is the recommendation for Indians three whole eggs in a week is not a problem if you are going to eat some people do this 21 eggs in a day for bodybuilding that is going to be a problem they don't eat yellow if it includes yellow 21 per day is a problem if it doesn't then again 21 eggs is not healthy something that is good the next question is from Rohit why is salt unhealthy salt is not unhealthy if you are not a part of your healthy diet sodium is very much important to regulate various body functions it maintains your blood pressure but too much of anything is always bad so excess sodium or excess salt is bad but the recommended amount of salt as in what is recommended is 6 grams per day that is 1 to 1.5 teaspoon of salt in a day is not unhealthy it is required how bad is high fructose corn syrup how does it affect brain, body and other organs ok high fructose corn syrup is something that is made from corn it is a sweetener made from corn starch it is a processed sweetener and as it is with every other sweetener which is made artificially or derived artificially from products it can lead to high insulin levels it can raise your sugar levels it can lead to obesity in the long run so all these chronic lifestyle diseases are linked to high fructose corn syrup I think it is by itself it may not be harmful but then it always is linked to many other additives and chemicals which is usually part of processed foods so in that way avoid anything that contains HFCS as in processed foods ok so there is a question from Prashant how is brown bread better than white bread I mean I don't know who told you brown bread is better than white because what we have available here locally at least both are same brown bread is made of wheat and white bread is made of maida then again we cannot generalize saying all brown bread will be made from whole wheat they may still be made from refined flour and then they could be having caramelized colouring to get that brown colour so we have to be sure you have to check the label if it says whole wheat flour then that is made from whole wheat if it says wheat flour it is still refined flour so next question is from Pooja is eating maggi really bad for health some kind of controversial question I guess we need not answer this so next question is from Sangeeta what meats are not safe to eat while pregnant that's important so pregnant women are advised to take a lot of proteins but then the sources of those proteins will still need to be seen very carefully fish especially sea fish are poisoned with mercury now we have mercury poisoning in our lakes and rivers and seas but in India we don't have any statistics or data as such to know which fish will have less of a mercury which fish has more so to be on the safer side we say minimize your intake of sea fish or any kind of fish in pregnancy could be just one serving in a week all of the protein could be safe as far as it's cooked properly thoroughly and at home any kind of meat is fine it's fine but then it's again it's based on the prescription by the doctor and then the dietation you should not be overdoing any of the things the next question is from Anagam is it safe to eat sweets coated with silver foil it's not safe to eat sweets even without silver foil I guess that answers the question minimize anything occasionally is fine anything you're overdoing in a day is bad so there's a question from Aaron I'm not sure what's the question is is fat rise or Kerala rise good for health fat rise I don't know maybe boiling is a referring to boil rise I think the shake of the rice yeah they are good for health whatever you know that we have been traditionally eating I think Kerala eats a lot of brown rice and red rice and the fat versions of the rice it's absolutely healthy you just need to see the quantity overall quantity so next question is from Shoaib Sheikh how much water should a normal healthy adult drink on a daily basis to avoid dehydration yeah that depends from region to region and your activity levels if you're very active sweating out a lot and if it's very humid then you will need to step up your intake of water key to know this is to test the color of the urine if it is clear then you're getting enough water and you're well hydrated if it is darkish if there's very little urine production you're obviously dehydrated you need to step up the intake of water there's no recommendation as such I mean there's always this myth that 8 glasses in a day each person may need different amounts of water based on their activity drinking more water does it have any kind of side effects? it may have if you're working out heavily and if you're an athlete or a sports person if you're overdoing just plain water it can be harmful it can even be fatal so you need to see what kind of activity level you have depends upon the body weight not only body weight the kind of activities for a normal sedentary person overdoing on water intake is not necessarily a great idea I have heard drinking more water leads to increase in metabolism rate is it true? again we need to define what is more and what is less for each person that is different for each person still hydrated there's no need to there's no reason why you should double your intake of water in a thing just because it boosts metabolic it doesn't boost anything other than filling up your stomach so this is a question from Laoprit Singh I want to gain some weight can I know some supplements for that? ideally we don't recommend supplements to gain weight you should consult a doctor or a dietician ideally to get your balanced weight gain diet and then follow it meticulously the next question Nisha Verma is asking how many food groups are in the food guide pyramid very technical I think probably studying masters as graduation and nutrition she has one more question you can answer it all together how many servings from each food group do I need each day I think if you have seen the food pyramid it answers all your questions possibly it's available online you could download the dietary guidelines for Indians online it's a PDF document and it's easily available for public view as well so that mentions the entire food group and the servings I can just tell one or two because it's a long list we may not be able to cover series I need to 30 grams is what we define as a serving so 12 servings in a day of series preferably whole grains and dairy products that is milk ideally you should get 3 servings so each serving being 100 ml in volume so the other things there are different things for vegetables there is 100 grams as a serving and you should get at least 3 to 4 servings in a day so there is a long list you could download that PDF and you know see so we have a question from Guludharsan is it healthy for children to be on vegetarian diet vegan diets yeah it is possible to be healthy on vegan but then you need to carefully balance it you should ideally get a prescription and diet plan from a professional dietitian to do this so it's not healthy it is healthy but then it needs to be planned by a professional dietitian you may not know what is a good source of protein how to eat and how to balance eating dairy products because vegan diets also leave out dairy products and all kinds of meats are out it's just vegetables and grains and all that so you need to know what will be a good source substitute for milk you could get it from almond milk for instance but then you need to know what amount is safe for the child and all that so friends we have come to the end of the questions so from today's episode we are introducing a new segment in health vibe show that is so in this segment what's going to happen is we will be asking the questions related to various myths related to various health disorders from the doctors so regarding diet and nutrition there are lots of myths for example there is one myth that is drinking green tea yeah it leads to increase in the rate of metabolism rate and it leads to decrease of weight it helps in weight loss so is it true there is a lot of conflicting evidence there are lots of branded companies who are highlighting with lots of brand ambassadors green tea is good for health I read a joke somewhere that green tea will help you lose weight only if you climb the mountain and pick the green leaves yourself I have been drinking green tea from last 2 years nothing has happened so there you have there is a lot of conflicting research happening one body of research says it's significant but some amount of weight loss is possible there is another body of evidence which says it's useless but then you need to know that all these studies have used green tea extracts which is a very highly concentrated source of green tea and not the cup of brewed tea that we have and whatever other research studies that have used green tea in the cup itself and in the liquid have used up to 10 cups a day so we still don't know what are the toxic side effects of that it is high caffeine and caffeine is not to suppress appetite in the lung so that way it may work it may suppress your appetite and then lead to decreased index by leading to weight loss but then the weight loss achieved in all these studies are very insignificant but then having said that there is no strong backing of evidence for no backing of evidence as far as weight loss is concerned but it's a great source of antioxidants there is polyphenols there is catechins and it is a great source of antioxidants so you still can't go ahead and have 2-3 cups of green tea in a day but then it needs to be backed by a healthy lifestyle and balanced diet by itself green tea will not do anything so viewers there is one more myth that is myth number 2 there is a concept called detoxification so whenever some person wants to reduce weight they say that first 2 weeks you undergo this process of detoxification is it true? this is again not backed by evidence and no national guidelines I have seen many these health clubs or whatever fitness groups promote a detox diet but there is no evidence no scientific evidence whatsoever and no national guidelines prescribe a detox diet firstly there is no such thing as a detox diet you should be ideally detoxing every day and the best way to do is plenty of fresh fruits and vegetables they are the best detoxified agents drinking neem juice? I don't think there is no evidence for all these things that is something that you make from your kitchen shelf using locally grown freshly produced plants and vegetables it's safe but then whether it will detox you to whatever degree there is no evidence and then we need to what is detoxification? some vague idea what is detoxification? no exactly I would also want to know what is meant by all these popular terms used detox ideally would mean I guess supplying more antioxidants now you have heard of free radical damage that is so popular now so many things can do that your diet itself it's a natural product of metabolism it's a natural product of digestion so there are plenty of free oxygen radicals that are released in the body there is a normal process and then pollution cigarette smoking alcohol all of them also contribute to free radical generation now these free oxygen species what they can do is attach themselves to other healthy cells and then damage the entire DNA of the cells now this kind of damage is known to lead to chronic lifestyle diseases could be cancer it could be diabetes it could be heart disease as an inflammation and all that so whatever stops these free radicals from damaging are called antioxidants so these themselves are promoted as detoxing agents which you might as well very well get from a very diet including plenty of fresh fruits and vegetables yourself so what you are doing is supplying a lot of antioxidants that will stop the free radicals from doing further damage so that is the take on detox so viewers we have come to the end of this show so we know that from September 1st to September 7th we celebrate diet and nutrition week so ma'am what message you want to give to the viewers related to diet and nutrition as Nisham has rightly said this is national nutrition week which kicked off yesterday in Maripal hospital as well this is a nationwide event actually started in 1982 by the government to you know intensify nutrition awareness among public because today we have on the one hand malnutrition where gross of children are suffering from energy and protein malnutrition anemia and lack of calcium and all that on the other hand we have obesity which is also another form of malnutrition so to address and promote awareness and to you know do the myth busting activities we have a lot of events planned in our hospital there is poster display everyday there is a contest and quiz and all that all that will go a long way to increase your awareness and you know and then if you know better you can promote it to your friends and colleagues so that is the basic idea so I welcome everybody to attend this event which is ongoing till 7th September so it was our privilege to have you in this show ma'am so on behalf of all the viewers I would like to thank you for coming over here and sharing your white knowledge regarding diet and nutrition so friends we will be coming with the next episode very soon till that stay tuned stay healthy stay happy stay cool thank you