Diabetologists have shown that reducing carbohydrate intake could result in remission of diabetes.
A recent study using the Indian Council of Medical Research-Indian Diabetes (ICMR-INDIAB) data has shown that by reducing carbohydrate and increasing protein and fat in the daily diet, diabetes progression can be controlled.
R.M. Anjana, Vice-President of Mohan Diabetes Research Foundation (MDRF), led the study that is based on the food habits of 18,090 adults across the country.
The Indian diet comprises 65-70% carbohydrates, 10% proteins and 20% fats. The carbohydrates could be rice or wheat-based items. The composition of food could be slightly altered to prevent the progression from pre-diabetes to diabetes, Dr. Anjana said. This could be achieved by maintaining the carbohydrate content at 54%-57%; protein at 16%-20% and fats at 20%-24%, she said.
She suggested the ‘plate concept’ to change the proportions: “You have a round plate. Draw a vertical line across the plate. Fill one half with green, leafy vegetables. Draw a horizontal line across the other half and make it two quarters. One is for carbohydrates and the other for proteins, such as chickpea, legume and such.”
This is in contrast to the normal pattern of having more rotis and just a small cup of vegetables, she pointed out. The rest of the carbohydrates would come from tea, coffee, milk and fruits, she added. Since proteins offer satiety, it is good to focus on them, she explained. For the study, the researchers asked every fifth person about their dietary habits, thus preventing bias in the sample, Dr. Anjana said.
V. Mohan, director and chief of diabetes research at the MDRF, said a recommendation to the population to alter the diet composition was necessary, as in another 20 years, the diabetic population could reach around 130 million. Currently, it stands at 74 million. As many as 80 million are in the pre-diabetic stage, he said. “We need to prevent people moving from pre-diabetes to diabetes. If possible, even make them normal,” Dr. Mohan added.
“Even a 10%-20% reduction in carbohydrate intake can do wonders. Increasing protein slightly and eating healthy monounsaturated fats such as nuts, fish or natural vegetable oils, will ensure a healthy balanced diet,” he explained.
“For the first time, we are seeing that even modest changes can reduce the diabetes epidemic, help to slow it down and even prevent it. It can lead to the remission of the condition,” Dr. Mohan added.
The study Macronutrient Recommendations for Remission and Prevention of Diabetes in Asian Indians Based on a Data-Driven Optimization Model: The ICMR-INDIAB National Study was recently published in Diabetes Care.
Seshadri Srinivasan of Kalasalingam Academy of Research and Education, who did the quadratic programming problem, said the ICMR-INDAB data was used for mathematical modelling, enabling the prediction of remission and prevention of diabetes at the population-level.
Sudha Vasudevan, head, Department of Foods and Nutrition Research, MDRF, said the recommendations would vary based on age, sex, body weight, urban and rural areas and activity levels. The study has called for “new dietary guidelines that recommend appropriate changes in macronutrient composition” to reduce the burden of diabetes across South Asia.
