New Delhi: No sugar for infants and toddlers till the age of two, only 5 percent of daily calories from sugar, at least 500 gm of fruits and vegetables in daily meals — these are some of the highlights of the National Dietary Guidelines issued by the Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN).
These dietary guidelines also suggest people to avoid protein supplements in order to complete their daily protein needs.
Developed as part of the new guidelines, ‘My Plate for the Day’ recommends sourcing of macronutrients and micronutrients from a minimum of eight food groups, with vegetables, fruits, green leafy vegetables, roots and tubers forming essentially half the plate of the recommended foods per day.
Cereals and millets occupy the other major portion followed by pulses, flesh foods, eggs, nuts, oil seeds and milk or curd.
The previous such recommendations were brought out in 2011.
For the first time, the dietary guidelines also recommend adding varieties of oilseeds and nuts in daily diet, Dr Hemalatha R, Director, ICMR-NIN and chairperson of the expert panel which has prepared the guidelines, told ThePrint.
Foods such as nuts, oilseeds, fish, etc. are nutrient dense and are rich sources of good quality fats, proteins, vitamins and other nutrients, say the guidelines. Seeds like those of fenugreek, amaranth, flax, chia and basil have health promoting effects and can be consumed at least three to four times a week, it adds.
Intake of cereals should be limited to 45 percent of the total energy, while for pulses, eggs and flesh foods, the total energy percentage should be around 14- 15 percent; total fat intake should be less than or equal to 30 percent energy, while nuts, oilseeds, milk and milk products should contribute to 8–10 percent of total energy per day, respectively.
However, as per the data, cereals contribute to 50-70 percent of total energy per day, say the guidelines prepared by a team of NIN scientists with inputs from independent experts as well as the Niti Aayog.
As of now, pulses, meat, poultry and fish together contribute only 6 to 9 percent of the total energy per day as against the recommended intake level of 14 percent from these foods, say the 148-page guidelines.
“Through the new guidelines we have emphasised that the most logical, sustainable, and long-term solution to all forms of malnutrition is ensuring the availability, accessibility, and affordability of nutrient-rich foods while promoting consumption of diverse foods,” Dr. Hemalatha said.
She added that these guidelines contain scientific, evidence-based information facilitating the attainment of the goals stated in the National Nutrition Policy.
Focus on changing dietary pattern, disease burden
As per the NIN, 56.4 percent of India’s total disease burden is due to unhealthy diets. But healthy diets and physical activity can reduce a substantial proportion of coronary heart disease and hypertension and prevent up to 80 percent of type 2 diabetes, it adds.
While a significant proportion of premature deaths can be averted by following a healthy lifestyle, data from the Comprehensive National Nutrition Survey 2019 (CNNS) highlights that a substantial number of children show early indications of non-communicable disease (NCD) and its related risk factors like diabetes and hypertension.
“The presence of altered metabolic biomarkers in over half of the undernourished and normal-weight children and adolescents raise significant public health concerns,” it notes.
The latest guidelines add that the upsurge in the consumption of highly processed foods, coupled with reduced physical activity and the limited access to diverse foods, exacerbate micronutrient deficiencies and the overweight/obesity problems.
Research indicates that unhealthy, highly processed, high-fat, sugar and salt (HFSS) foods have become more affordable and accessible than the healthier alternatives, they add.
Aggressive advertising and marketing of these unhealthy foods through media channels, including social media, are seen to influence dietary preferences among both children and adults, leading to detrimental long-term effects, according to the NIN.
Also, a large chunk of family income is spent on buying such unhealthy foods. This faulty dietary pattern, it says, contributes to deficiencies in iron and folic acid, resulting in anaemia and in the higher prevalence of overweight and obesity among population groups.
Variety: the key
The guidelines say that there should be inclusion of non-starchy fresh vegetables and green leafy vegetables in every meal and everyone should take at least 30 grams of fruits in every meal.
Also, the public are advised to consume at least 50 percent of cereals and other grains as whole grains (minimally polished) for adequate nutrients and fibre while all cereal (or millet) based diets should be accompanied with adequate pulses or beans for good quality protein and fibre.
Consuming adequate quantities of nuts, oilseeds, fatty fish and restricting cooking oils to 25g to 30g per day is also listed as a healthy habit.
The guidelines also advise restricting meal frequency to two-three times a day and to avoid ultra-processed foods and foods high in fat, sugar and salt.
Avoiding sugar or restricting to 20 g to 25 g per day for adults, not snacking in between and consuming healthy beverages, including variety within food groups are also identified as good habits.
For example, different types of cereals, millets and pulses have different nutrient profiles; hence a variety of cereals, millets and pulses are recommended to be consumed on a daily basis for adequacy of different nutrients. This applies to other food groups such as vegetables and fruits as well.
In the case of vegetarians, the guidelines say, achieving adequacy of essential long chain n-3 polyunsaturated fatty acids (PUFA) and B12 is a challenge. So, they may take foods fortified with these nutrients or must ensure adequate intake of n-3 PUFA rich foods (flax seeds, chia seeds, walnuts, vegetables and greens). For tackling the deficiency of Vitamin B12 which is common among vegetarians, milk can be an option.
Many athletes consume very high amounts of protein, often in the form of protein powder, unlike the body requirements that are not as high as commonly perceived, it observes.
In fact, it states, research findings indicate that dietary protein supplementation is associated with only a small increase in muscle strength and size during prolonged resistance exercise training (RET) in healthy adults; and protein intake levels greater than ~ 1.6 g/ kg/ day don’t contribute any further to RET-induced gains in muscle mass.
“Consuming high levels of protein, especially in the form of protein supplement powders, is not advisable,” it says, adding that even most athletes can get the recommended amount of protein through food alone.
Prolonged intake of a large amount of protein is associated with potential dangers, such as bone mineral loss and kidney damage, it warns.
Commenting on the latest guidelines, ICMR director general Dr Rajiv Hahl stressed that the dietary habits of Indians have undergone significant changes over the past few decades, leading to an increase in the prevalence of non-communicable diseases while some of the problems of undernutrition continue to persist.
“I am pleased that these guidelines have been made very relevant to the changing food scenario in India with addition of practicable messages and suggestions on handling food safety, choosing minimally processed foods, importance of food labels and physical activity,” he said.
(Edited by Tony Rai)
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