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"Go Back to Brown" - More on chronic disease, specifically cardiovascular disease

4/2/2018

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For the next few weeks, I am putting passages from our fantastic book "Go Back to Brown" here on this blog. If you are interested in the book, which explains some simply ways on how to make Indian food healthier, click on this link to Amazon. It is available in both the Kindle e-book format and paperback.

According to the WHO, cardiovascular disease (CVD) accounts for 17 million deaths worldwide. Coronary arterial disease (CAD) is the most common form of CVD, and the leading cause of death in both men and women in the United States. CAD is defined by the buildup of a waxy substance called plaque in the vessels that supply the heart with blood carrying oxygen.

As the plaque builds up, it hardens or sometimes ruptures. Hardened plaque narrows the blood vessels and reduces the flow of blood to the heart downstream. When a plaque ruptures, it can become lodged in a narrow part of the vessel, which can partially or completely block the flow of blood to that part of the heart muscle. What we call a heart attack (or myocardial infarction) is the usually the result of a blocked (occluded) coronary artery.

Indians have some of the highest mortality rates from CAD. And clinically significant CAD tends to develop it 10 to 15 years earlier than it does in most other ethnic groups in the US. Indians also develop CAD at lower body weights compared to other ethnicities based on studies on Indian immigrants in the UK and Canada.

Our relatively high risk for developing cardiometabolic diseases is due to a combination of genetics, lifestyle, and diet. Though traditional risk factors—high cholesterol, high blood pressure, smoking, and obesity—play an important role in heart disease, these risk factors alone don’t explain the unusually high prevalence of CAD in the Indian community.

Hyperinsulinemia (or abnormally high levels of insulin in the blood) caused by insulin resistance is very common in South Asians and could explain some of the increased risk we see for these diseases among our community.

Further, genetic factors that lead to both increased fat storage around internal organs in the abdomen (which is called visceral fat) and increased production of molecules carrying cholesterol in the bloodstream (called lipoproteins) are probably additional underlying mechanisms related to the high rates of these diseases.

South Asians tend to have central obesity (characterized by a large waist-to-hip ratio) due to excess visceral fat. This is due to genetics in part, something out of our control. But we can control our lifestyle and our diet, which also contribute to visceral fat. We can increase our physical activity, quit smoking, and deal with stress and anxiety better. As we will discuss in this book, we can make small changes to what we eat.
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"Go Back to Brown" - On chronic diseases including diabetes

4/2/2018

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For the next few weeks, I am putting passages from our fantastic book "Go Back to Brown" here on this blog. If you are interested in the book, which explains some simply ways on how to make Indian food healthier, click on this link to Amazon. It is available in both the Kindle e-book format and paperback.


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Among the general US population, 7 out of every 10 deaths annually are from chronic diseases like heart disease, diabetes, and cancer. Together heart disease, cancer, and stroke account for more than 50% of all deaths. These chronic diseases accounted for more than 50% of all deaths in India as well.

Of the major chronic diseases, Indians are especially vulnerable to heart disease and diabetes.

Because of a genetic tendency and changes to our diet and lifestyle, Indians have some of the highest rates of type 2 diabetes, coronary artery disease (CAD, also what is often referred to as “heart disease”), and obesity compared to all other ethnicities in the United States.

Type 2 diabetes mellitus (what we simply will call "diabetes") affects about 350 million people worldwide. The World Health Organization projects that diabetes will be the 7th leading cause of death by 2030.

India has both the second-largest number of people with diabetes in the world. Of all racial/ethnic groups in the States, Indians have the highest diagnosed type 2 diabetes rate at almost 18%.

When blood sugar levels remain chronically elevated over months to years, our bodies respond by trying to keep insulin levels high to help bring sugar levels down to a normal level. Constantly high insulin levels desensitize cells to insulin’s effect, resulting in insulin resistance. Insulin resistance is the mechanism that leads to type 2 diabetes.

Diabetes occurs either when the body no longer produces enough insulin or when the body’s cells are no longer responsive to this hormone. When we eat and absorb carbohydrates (e.g., sugar, starches), our blood sugar (plasma glucose levels) goes up.

Insulin encourages cells to remove glucose from the blood for use immediately as energy or to store it for later use. If insulin cannot communicate this signal to cells effectively or if there is not enough insulin produced (as in type 1 diabetes), glucose will build up in the blood and eventually lead to complications such as damage to the heart, blood vessels, eyes, kidneys, and nerves. The debilitating effect of diabetes on the heart is especially concerning considering up to half of diabetics will die of cardiovascular disease.

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"Go Back To Brown" - An Introduction

4/2/2018

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I took three years off from writing here on this blog dedicated to healthy Indian food because I reached a point where I was not saying anything new. It was basically processed carbs are bad, we should eat more vegetables and even fats, and spices have great benefits for health, recycle and repeat.  

Plus our family grew, and my job got busier. So it was a needed break. During this time, things percolated in my mind, and I think I have a few fresh things to say which I will add to this blog over the coming months. 
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First I want to post passages from a book I had played a small role putting together. Four of us - Magi who is a now a medical resident at UC-Davis, Latha who is a physician and researcher at Stanford, Geetha who is a dietitian and researcher at the Palo Alto Medical Foundation, and myself - teamed up to figure out how to make Indian food healthier. This was back in 2015. What was born the next year was "Go Back to Brown". They did an absolutely amazing job with this book! 

I will post excerpts from the book (with some edits to make them easier to read) in the hope that the message reaches a wider audience. If you would like to get a copy of the whole book, click the book image below. It will take you to the Amazon page.
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Chances are, you know someone in your family who has heart disease [or] diabetes. Turns out you aren’t alone.

Indians all over the world, including those in South Africa, Canada, Singapore, Fiji, Mauritius, United Kingdom, and the United States have reported high rates of chronic diseases, especially heart disease... Studies show South Asians (Indians, Pakistanis, Nepalis, and Bangladeshis) living in the United Kingdom have up to four times a greater risk of developing heart disease than other racial/ethnic groups and at a younger age!

This isn’t surprising considering the lifestyle transition we have made into the twenty-first century; Modernization, urbanization, and technology have reduced the amount of physical activity we do on a daily basis. Our jobs are less physically demanding than before, and most of us spend the lion’s share of the day sitting, either in front of a TV/computer or in a car. When we come home, our families and chores usually take priority over going to the gym or a quick jog, even if it was on the agenda. Or we easily think of various reasons why we can’t work out: “I have a headache.” “I am too busy and/or stressed.” “I just want to relax.”

And we prefer to eat traditional, home-cooked Indian food—the way we ate growing up—yet our time constraints sometimes limit us to more packaged, processed, and refined Indian foods.

Compare this to the way our grandparents lived: everybody typically walked everywhere, knew where their food came from, and ate meals that were freshly prepared, not prepackaged or microwavable. Our diet and lifestyle have changed dramatically since our grandparents were our age, and our mental and physical health is paying the price.

Expanding waistlines aren’t only evident in US immigrants. Indians at home and abroad are besieged by the twin epidemic of diabetes and heart disease. This may seem puzzling considering most Indians around the world eat a diet based on vegetables, grains, and pulses (edible seeds, such as peas, beans, lentils) plus occasionally meat for [many].

A typical Indian meal may consist of flatbread (roti) or rice, stir-fried vegetables (sabjee), lentils (dal), and yogurt (curd). This would lead you to believe that the modern Indian diet is “healthy.” But considering alarming rates of chronic diseases common in the Indian community today, we need to rethink our diet. We must reevaluate the modern Indian diet and make necessary changes to ease the burden of these diseases.

Although there are many reasons for increased risk and prevalence of chronic diseases in the Indian population (e.g., genetic, cultural, lifestyle), this book considers how the modern Indian diet, one high in refined carbs and low in fiber, increases the risk of developing health problems such as high blood pressure, elevated insulin levels, excess body fat around the waist, and abnormal cholesterol levels. We review how the traditional Indian diet transitioned to include refined products, and how our lifestyle and culture have led to unhealthy eating habits.

Carbohydrates are integral to Indian dietary traditions, so we offer a way to reintroduce nutritious ancient whole grains (higher-quality carbohydrates) to help prevent and reverse today’s common nutrition-related disorders. We call this “B2B,” going “back to brown.”

Stay tuned for the next excerpt, which will be posted here in the near future. For the book, click here.

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Is it okay to eat eggs?

2/25/2015

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The answer seems to be yes. For the longest time, we thought the answer was no. Experts said to not eat eggs everyday, especially not the yolks, because they are full of cholesterol. And eating too much cholesterol would increase the amount of cholesterol in your blood. 

However, the body produces cholesterol. And when we eat cholesterol, the exquisite machinery that is our body makes less of it to keep the level in our blood relatively stable. According to a recent interview by an NPR reporter on a US government panel looking at making new diet recommendations:

"AUBREY: ... A lot of us grew up thinking eggs were a no-no, right? Back in the 1970s, that's when experts first started making links between heart disease and diet. And that's when dietary cholesterol was really fingered as a problem. Now, cholesterol is found in animal products - meat, eggs, cheese, butter. And the thinking was that the amount Americans were eating was responsible for the increasing prevalence of heart disease.

"SIEGEL: And what's happened now?

"AUBREY: Well, in short, as researchers have continued to study this, they've concluded that there's really not strong evidence to support the idea that eating a lot of cholesterol in foods leads directly to higher amounts of bad artery-clogging cholesterol in our bloodstreams.

"In fact, the American Heart Association changed its policy on dietary cholesterol in 2013, citing insufficient evidence on this link. And that's the new science that the dietary guidelines committee is responding to. Now, I should point out that their final report has not been released yet, so the details of their message on cholesterol is just not clear yet."



The Atlantic Monthly's health and medicine blogger James Hamblin explains that these recommendations reflect a comprehensive change in what experts believe is good in terms of food for good health.

"The 15-person advisory committee's new recommendations are emblematic of an essential ongoing shift in approaches to eating: focusing on whole foods, as opposed to avoiding or endorsing specific macronutrients (carbs, fat, or protein). Where nutrients are mentioned in the committee's recommendations, there are a few notable moves. Cholesterol in food is no longer cause for concern—vindicating the once-forsaken egg yolk and its arbitrary "62-percent daily value" of cholesterol, as current nutrition labels read. Only certain kinds of dietary fat (trans and saturated) are to be minimized, and whole grains are—starkly counter to the national trend in low-carb and gluten-averse ideologies—second only to fruits and vegetables as the most "health-promoting" foods that a person can eat."

This panel convened by the U.S. Depts. of Agriculture and Health and Human Services also recommends we eat less red meat and processed meat, less sugar-added food and drinks, and less refined sugar in general -- recommendations we have in fact made here on this blog many times. Interestingly, we're to eat more seafood too.

Perhaps the most controversial recommendation -- well, the one that got the acclaim and the headlines in the media anyway -- is the one that says we can eat food that is filled with cholesterol. This is probably because experts acknowledge our bodies will adjust how much cholesterol is made available in our blood based on much cholesterol we eat. That is why, according to newer science, eating eggs is all good.

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If you want to lose weight this year, check out our new book!

1/6/2015

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I'm proud to introduce "Lose Weight the Healthy Indian Way", a simple guide on how to lose excess body fat. You'll find practical advice based on science and easy to adopt. No complicated meal plans. No strict diet rules. 

Just guidelines and tips that when followed fairly consistently for 6 weeks will help you lose excess body fat. You'll learn secrets like:

* The best approach to aerobic exercise, an approach that will save you time and increase how effective your efforts are

* What carbs are actually bad (not all of them are!)

* Being a perfectionist is the worst thing to strive for

"Lose Weight the Healthy Indian Way" is currently available by Amazon Kindle (the device and the app, which can be downloaded for free on your Apple, Android, and Microsoft devices). We plan to make this available on other formats too. If interested, please email us at info@healthyindiandiet.com. 


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Read "The Healthy Indian Diet" for a good start to the new year!

12/31/2014

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Our book "The Healthy Indian Diet" turned 3 years old in 2014! Thousands of people like you picked up a copy and got something useful for life out of it. We've in fact heard from many of you, and it's been encouraging to hear how the book has helped change lives in small ways and big.

If you haven't read our book before, you should know the book is divided into two parts. 1st comes the science. About that part, one reader says:

"I thought this book was a very interesting read. The first part of the book focuses on the science of diseases that can be affected by diet and breaks down food and how it affects your body. I feel like the author did a really good job of putting in details but still making the book understandable for a regular person."

The 2nd part is the cookbook full of wonderful recipes. Says another reader:

"The Healthy Indian Diet has now become a staple in our home-cooking reference library and repertoire. We love South Asian food and are vegetarian. Raj's informed approach to nutrition and food is an excellent guide to developing quick, nutritious and balanced meals with exciting South Asian flavors. The lima bean curry has become a favorite of ours - quick, tasty and super easy to prepare! ..."

We've had many satisfied readers, such as this one who says:

"Reading the book has helped us make healthier choices while still enjoying the richness of Indian food. The book carries recipes, but it's not a traditional cook book. Any one book that covers Indian food as diverse as dosas, Bengali fish curry, and Gujarati daar, would have to be five times larger to be comprehensive. Instead, the book seems to aim towards providing a sampling of recipes that along with the explanations in the first half, give readers the tools necessary to make adjustments to all of their dishes. The book has been helping my wife and me make appropriate adjustments to our mother's recipes so we still enjoy the foods that we grew up with but in a more healthy way."

We hope you are encouraged to pick up our book. Even if not, we hope you are encouraged to have a better 2015!

To get a free sample of "The Healthy Indian Diet," go to the Amazon webpage and click "Look Inside". You can buy this book in paperback or for the Kindle off Amazon, and it's available for other formats too.


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Recipe for Lentil Vegetable Stew using a Slow Cooker

12/22/2014

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My friend Amee runs a great site called RabbitFoodRocks. Funny, poignant, and full of wonderful recipes, I recommend you check it out if you want to try something new. Even if you're not a hard-core vegetarian. After all, even meat-lovers must eat their plants.

Here's a wonderful recipe for a hearty meal perfect for the wintertime when it’s cold outside. You will need a slow cooker (which is an awesome thing to have if you’re the busy type that isn’t too fond of cooking).

What I like about this recipe is it contains some basic ingredients in the Healthy Indian Diet: lentils which pack fiber with a decent amount of protein and a variety of vegetables which are full of nutrients. We modified Amee’s recipe a little by adding our own spices, not using celery, and using extra virgin olive oil. (That's my beautiful wife's hand mixing the dal in the photo to your left.) 

That’s part of the beauty of this recipe: it’s versatile, you can do it how you like, and there’s no way to mess it up. It’s also filling and smells and tastes great!

Ingredients and directions for Amee's Lentil Vegetable Stew recipe are reprinted below just as written on the original place she first posted her recipe. Enjoy!

Slow Cooker Lentil Vegetable Stew

Ingredients:

1 cup brown lentils
4 cups water
2 Tablespoons grapeseed oil
1 cup finely diced celery (with leaves if you can!)
1 cup finely diced onion (yellow or white)
1/2 cup finely diced carrot
1/2 cup finely diced sweet potato
2 bay leaves
1 Tablespoon Better than Bouillion
1 15-oz can diced tomatoes
2 packed cups of chopped kale
1/4 cup chopped parsley

Directions:

1. Plug in slow cooker and set to 4-6 hrs of cooking time.  (At the four hour mark, the lentils should be tender to the bite, but the acidity from the tomatoes impedes cooking time of the lentils…you shouldn’t need more than 6 hrs).  Add the water and the lentils to the crockpot [slow cooker].

2.  Heat oil in a sautee pan on medium high heat, and saute the onions, celery, carrots, sweet potatoes, and bay leaves.  Cook for about 4 minutes and remove from heat.  Add the sauteed vegetables, the tomatoes, and the bouillon to the slow cooker.  Cover.

3.  After 4- 6 hours, wilt in the kale and parsley, and serve with crusty french bread or crackers.



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If you adopt a new diet in 2015, make sure it NOT low-fat

12/18/2014

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I want to share a recent essay by Nina Teicholz published in the Wall Street Journal (she wrote the popular book "The Big Fat Surprise"). You may be able to read the whole essay by clicking here. Or you can search "Last Anti-Fat Crusaders" on Google and click the link. 

Moving on, the hook of Ms. Teicholz's essay is that a top scientist advising the US government on nutrition policy had said that low-fat diets are "probably not a good idea". In her opinion, this constitutes a shocking admission because for decades now the US government has blamed fats for heart disease and other ills and continues to promote low-fat diets. 

To this day and every year, a large number of Americans strive year to eat low-fat foods. This despite a retreat on the anti-fat message in some quarters, such as Harvard's school of public health.

Why the retreat? Because low-fat foods are the problem people!   

"By the turn of the millennium, however, clinical trials funded by the National Institutes of Health (NIH) were showing that a low-fat regime neither improved our health nor slimmed our waistlines," she writes.

As I have written about in this blog before, a lot of scientific evidence generated in the last 1-1/2 decades, evidence published in respected journals, consistently show that low-fat diets do not reduce one's risk for deadly heart-related events or one's tendency to gain weight. 

Truth is most scientific trials on diets that compare low-fat to low-carb diets show that low-carb diets outperform low-fat diets when it comes to improving people's health. Writes Ms. Teicholz:


"[A] low-carbohydrate regime consistently outperforms any other diet in improving health. Diabetics, for instance, can most effectively stabilize their blood glucose on a low-carb diet; heart-disease victims are able to raise their 'good' HDL cholesterol while lowering their triglycerides. And at least two-dozen well-controlled diet trials, involving thousands of subjects, have shown that limiting carbohydrates leads to greater weight loss than does cutting fat."

This is something worthwhile to keep in mind when come this January 1st when you decide to change your diet. Cheers and have a wonderful new year!
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Recipe for Oven-Baked Cauliflower Curry

9/24/2014

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My friend Amee Meghani runs a great vegetarian food & recipe site called RabbitFoodRocks. At times funny, at times poignant, and always full of wonderful recipes, I recommend you check it out if you want to try something new. Even if you're not a hard-core vegetarian. After all, even meat-lovers must eat their plants.

Here's one wonderful recipe from her site I like because it highlights some things we talk about here on Healthy Indian Diet: eating a variety of vegetables is good, adding spices like turmeric to what we eat makes it better, and cooking in butter or ghee is absolutely okay. And it must taste good!

Ingredients and directions for Amee's oven-baked cauliflower recipe are reprinted below just as written on the original place she first posted her recipe. Enjoy!

Oven-Baked Indian Cauliflower Curry

Ingredients:

1 head cauliflower
2 Tablespoons ghee or butter
2 Tablespoons grapeseed oil
1 serrano pepper, seeded, minced
1 onion, finely diced*
1 inch fresh ginger root, grated
5 cloves garlic, minced
1 teaspoon ground coriander
1 teaspoon ground cumin
1/2 teaspoon turmeric
1/4 teaspoon cayenne
1 teaspoon garam masala
1 teaspoon salt
1 can of petite diced tomatoes, pureed
2 Tablespoons chopped cilantro (optional for garnish)

Naan, flatbread, tortillas, or cooked rice for serving (optional)

Directions:

1.  Preheat oven to 375 degrees. Trim the cauliflower into 1-inch chunks.  Stalks are great – use them too! The important thing is that the cauliflower pieces are close to the same size as each other. You want them to bake at the same rate. Rinse and set aside. 

2.  Combine cumin, coriander, turmeric, cayenne, and garam masala in a small bowl.

3.  Make the sauce (masala): Heat oil and butter/ghee in a wide deep saucepan or skillet over medium-high heat. Add minced serrano and diced onion and sautee until onions are almost translucent. Add the ginger and garlic and cook for 2 minutes, stirring frequently, making sure the onions and garlic don’t burn. Then add your spices. Cook for 1 to 2 minutes, stirring continuously.  Now add the salt and pureed tomatoes. Cook for about 2 to 3 minutes and remove from heat.

4.  In a large bowl combine cauliflower and the sauce.  Mix well, making sure all nooks and crannies are covered with the sauce.

5.  In a lightly greased casserole dish or pyrex dish, spread the cauliflower in one shallow layer.  Loosely cover with foil.  Bake on the middle rack for 35 minutes**.  Then uncover and Broil on HI for 10 minutes, but be sure to watch it closely, because broil results can vary significantly.  The purpose of broiling is simply to crisp up the florets a little. They’ll turn brown–that’ll be the crispy part!–but we don’t want them to burn.

6.  Garnish with chopped cilantro. Serve with naan (or flatbread or tortillas), rice, or on its own (gluten-free!)

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Big NIH-funded Study Shows to Lose Fat, You Should Be Eating MORE Fat (Part 2)

9/15/2014

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Let's continue our closer look into a clinical diet trial that made a big splash 1-2 weeks ago. Click here to see my 1st blog post on this trial.

We will continue with this passage from the NYT article on this diet trial:
In the end, people in the low-carbohydrate group saw markers of inflammation and triglycerides — a type of fat that circulates in the blood — plunge. Their HDL, the so-called good cholesterol, rose more sharply than it did for people in the low-fat group.

Blood pressure, total cholesterol and LDL, the so-called bad cholesterol, stayed about the same for people in each group.

Nonetheless, those on the low-carbohydrate diet ultimately did so well that they managed to lower their Framingham risk scores, which calculate the likelihood of a heart attack within the next 10 years. The low-fat group on average had no improvement in their scores.

The decrease in risk on the low-carboydrate diet “should translate into a substantial benefit,” said Dr. Allan Sniderman, a professor of cardiology at McGill University in Montreal.


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