Mukti Sadhan Nath, Co-Founder & Executive Director, Azkka Pharmaceuticals

Headquartered in Ahmedabad, Azkka Pharmaceuticals is one of India’s leading pharmaceutical organization offering healthcare solutions to the medical fraternity and to the people in need of it, with its medicines & products of the highest standards.

Indians have become more affluent, urbanized and mechanized, since the previous decade. Hectic lifestyle and easy availability of convenience foods has led to irregular meals and frequent snacking on energy-dense fast foods and commercial fast foods rather than traditional home-cooked food. Overall, this nutritional transition has resulted in high consumption of calories, saturated fats, trans fatty acids (TFAs), simple sugars, salt, along with low intake of fiber, monounsaturated fatty acids (MUFAs) and n-3 poly-unsaturated fatty acids (PUFAs).

There is a significant shift in epidemiology of disease in India from communicable to non-communicable. According to the recent consensus, in India 22 percent of the adult population are obese, and deaths from complications of diabetes and cardiovascular disease combined account for 35 percent of total deaths. The World Economic Forum in its 2014 report stated, cardiovascular disease and diabetes contribute 50 percent loss in economic out-put for India from 2012-2030. This amounts to around 2.3 lakh crores and 17.6 million productive years lost.

Contribution (Percent) of Each Disease to Lost Eco-nomic Output for India, 2012-2030 INTERHEART study conducted in 52 countries, showed diet modification, exercise and smoking cessation would lead to 80 percent risk for myocardial infarction. It becomes imperative that Indians adopt therapeutic lifestyle modification, which includes evidence-based diet modifications along with exercise and cessation of smoking.

This article would lay emphasis on dietary fiber and Omega 3 fatty acids, and the importance of antioxidants, minerals and vitamins would be dealt with subsequently. For decreasing the risk of cardiovascular disease, the daily carbohydrate intake should be approximately 50–60 percent of the total calorie intake. The primary source of complex carbohydrates in the diet should be cereals and millets. Complex carbohydrates should be preferred over refined carbohydrates and its products.

Intake of dietary fiber (DF) through foods such as nuts, whole-grain flour, fruits, and vegetables decreases low-density lipoprotein (LDL) – cholesterol, improves insulin sensitivity, improves laxative properties and body weight regulation. There is consistent and strong data for the protection afforded by high fiber intake of greater than 25 grams per day against cardiac disease, obesity, diabetes and cancer of colon and rectum.

“Intake of DF through foods such as nuts, whole-grain flour, fruits, and vegetables decreases LDL – cholesterol, improves insulin sensitivity, improves laxative properties and body weight regulation”

Different processing methods like milling of grain to yield refined flour, canning of fruits, and vegetables cur-tail the supply of fiber from the diet. There is another challenge in current Indian diet, i.e., the average fiber content in all the vegetables and fruits we consume are only around three grams per 100 grams. So, there is a need to incorporate seeds and whole grains along with vegetables and fruits in our daily diet to meet the fiber requirement. Foods high in fiber include Salvia seeds, Flax seeds, oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries, and apple pulp.

Dietary fat includes both unsaturated and saturated fatty acids. The unsaturated fat is Monounsaturated fatty acids (MUFA) and Polyunsaturated fatty acids (PUFA). Monounsaturated fats are found in red meat, whole milk products, nuts, olives and avocados. Olive oil is about 75 percent monounsaturated fat. The Polyunsaturated fatty acids are Omega 3 & Omega 6 fatty acids. The Omega 6 fatty acids are abundantly present in various food sources like sunflower oil, safflower oil and corn oil. The three types of Omega 3 fatty acids are Alpha linolenic acid (ALA), found in plant, and Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA), both commonly found in marine algae and fish. Humans cannot synthesize ALA, so it is imperative to take plant sources rich in ALA (Omega 3 fatty acids). The daily requirement of ALA is more than two grams per day. The imbalance in dietary Omega 6 & Omega 3 PUFA is an important cause for the development of insulin resistance and dyslipidemia in Indians. The current Indian Diet has 20:1 Omega 6 to Omega 3 ratio, where the ideal is 5:1. The Omega 3 fatty acids have an anti-inflammatory effect, while Omega 6 fatty acids have inflammatory effects. A high proportion of Omega 6 to Omega 3 fat in the diet shifts the physiological state in the tissues toward the pathogenesis of many diseases: prothrombotic, proinflammatory and procon strictive. The substitution of unsaturated fatty acids for saturated fatty acids lead to decreased LDL-C levels.

Partially hydrogenated oils have been used in food for increasing product shelf life. Animal-based fats were once the only trans fats consumed, but by far the largest amount of trans fat consumed today is created by the processed food industry as a side effect of partially hydrogenating unsaturated plant fats (generally vegetable oils). These partially hydrogenated fats have displaced natural solid fats and liquid oils in fast food, snack food, fried food, and baked goods industries.

Trans fatty acids are not essential and provide no known benefit to human health, whether of animal or plant origin. Second, while both saturated and trans fats increase levels of LDL, trans fats also lower levels of HDL, thus increasing the risk of coronary artery disease along with obesity, diabetes, infertility, cancer, major depressive disorders and Alzheimer disease. To conclude, the dietary modifications with high fiber intake, avoiding refined carbohydrates, consuming more dietary fiber in form of seeds, whole grain and fruits along with high intake of plant-based Omega 3 fatty acids along with minerals, vita-mins and antioxidants will have a huge impact in decreasing cardio metabolic disease.