{"id":48290,"date":"2018-01-11T09:27:35","date_gmt":"2018-01-11T14:27:35","guid":{"rendered":"https:\/\/asweetlife.org\/?p=48290"},"modified":"2018-01-17T11:22:56","modified_gmt":"2018-01-17T16:22:56","slug":"exporting-americas-diet-a-peek-into-south-asias-growing-diabetes-problem","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=48290","title":{"rendered":"Exporting America\u2019s Diet: A Peek Into South Asia’s Growing Diabetes Problem"},"content":{"rendered":"

A recent NY Times article<\/a> discussed the \u2018volcano of diabetes\u2019 upon which India is sitting. The cause? A population predisposed to Type 2 diabetes, that has increasing access to America\u2019s favorite diabetes-linked consumables such as junk food, fast food, and soda. This is a new and growing problem, but luckily India\u2019s cultural relationship to \u2018Western\u2019 Big Food favorites differs greatly from America\u2019s\u2014in India, American fast food exists as a luxury or choice as opposed to a necessity. Combined with the growing awareness of the Indian population\u2019s unique predisposition to diet-related disease, India could pave a different path than we\u2019ve seen in the US, bending the curve in favor of public health sooner and more quickly.<\/p>\n

\u00a0<\/strong><\/p>\n

The state of the state:<\/h3>\n

India is facing a growing diabetes problem\u2014familiar news to American ears. The Times reports that since 1990, the percentage of children and adults who are overweight or obese has tripled. By 2040, the International Diabetes Federation projects that the number of Indians with diabetes will soar to 123 million. South Asians are more likely to develop the disease for many reasons, including body type (often referred to as thin-fat), smaller arteries, and a more sedentary lifestyle\u2014a myriad of factors that some chalk up to \u2018evolution.\u2019 But that doesn\u2019t mean diabetes is inevitable. Instead, South Asians need to be more mindful of lifestyle factors that lead to increased risk, such as diet and exercise.<\/p>\n

Which is why India\u2019s recent influx of Western fast food restaurants and junk food, two of the primary culprits in America\u2019s diabetes epidemic story, is causing waves. Big food companies such as McDonald\u2019s, Coca-Cola, and Domino\u2019s view India as a huge market opportunity, but public health advocates are fighting back\u2014with mixed results. As Ushakant Thakkar, a South Asian Nephrologist from Southern California, put it, \u201cWell-intentioned public health advocates will operate at a slower pace because Big Food has deep pockets. Big Food executives with good intentions get carried away because of their shareholder targets to show performance, and there they find a suitable shelter of \u2018feeding the world.\u2019\u201d This David vs. Goliath story is all too familiar to public health leaders in America.<\/p>\n

The Times\u2019 piece discusses one man\u2019s fight to ban junk food around schools. This effort is currently stalled in a bureaucratic vortex, highlighting the growing influence of big food on public health policy in India\u2014similar to the US. As Sahil Khanna of New Dehli notes, \u201cOne of the biggest issues India faces is the very patchy implementation and execution of the rules and policies already in place.\u201d But at the same time, India has had notable victories, including a proposed a 40% tax on soda. The U.S. soda tax fight has only had a handful of local victories thus far, so perhaps this is an indication of what\u2019s to come in India\u2019s fight to curb the diabetes epidemic\u2014perhaps an accelerated trajectory is possible in India.<\/p>\n

\u00a0<\/strong><\/p>\n

Why is the \u2018diet\u2019 problem different in India?<\/h3>\n

An Indian woman myself, I turned to several family members who have personal experience with Type 2 diabetes and junk food to understand the dynamics.<\/p>\n

\u00a0\"indian<\/strong><\/p>\n

    \n
  1. India\u2019s love of fast food is not new. <\/strong>Before there was Domino\u2019s, there was (and still is!) \u2018vada-pav<\/a>.\u2019 Major cities in India already have Indian \u2018fast food\u2019 staples available on most street corners. Unlike NYC hot dog carts which are rarely frequented by locals, the average Bombay-ite (including me when I visit) will gladly indulge in a fried spicy potato ball smashed between two pieces of white bread, or a host of other street-side fast food options. The entry of Western fast food hasn\u2019t created a new habit, it has only expanded the options for an existing behavior.<\/li>\n
  2. The \u2018cool\u2019 factor. <\/strong>The cultural role of Western fast food and junk food is different in India than in the US.<\/strong> In the US, fast food and processed food are perceived to be the only option in food deserts and low income communities. In India, fast food restaurants are considered an outing\u2014a place to take your family for a nice meal. This is due in part to the general glorification of all things \u2018Western.\u2019 Bansari Thakkar, a South Asian millennial, says, \u201cGoing to these Western type restaurants is the \u2018cool\u2019 thing to do, no matter how much it costs. Many people complain about 20 rupees ($0.30) for vada-pav, but don’t mind paying 70-80 rupees ($1.25) for a burger at McDonald\u2019s or 200+ rupees ($3.15) for a personal pizza at Dominos.\u201d As a result, India\u2019s fast food habit is much more a social experience than in the US. Rajeev Kakkad of Bombay says, \u201cIf you went to a large mall on a weekend, the fast food spots have huge lines, filled mostly with the aspirational crowd.\u201d Sahil Khanna of New Dehli notes \u201cEating out is a social thing here, and fast food chains with their reasonable prices and standardised meals are looked upon as a safe bet. Customers partaking in it regularly are mostly in the top 10% of the country’s income groups.\u201d Ushakant Thakkar remembers, \u201cWhen we were young, advertisements for Coca-Cola always featured a very handsome young man. You would think \u2018If you eat this food, you\u2019ll look more handsome.\u2019 It\u2019s a similar strategy as the Marlboro man for cigarettes. And in India, I think this strategy is really working.\u201d<\/li>\n
  3. But Indian food and flavors still win.<\/strong> While Indian street food is largely unhealthy, classic Indian staples are more balanced and fresh, and in many cases, preferred. According to Rajeev Kakkad, roughly 70% of his office will get the standard Indian meal for lunch at his office cafeteria\u2014including a roti (whole grain tortilla), subzi (vegetables), daal, and rice. The fact that India has such a rich and diverse food culture works to its advantage\u2014people love and embrace the flavors.<\/li>\n
  4. South Asians can count on the youth.<\/strong> In addition to the recent NY Times article<\/a> featuring Rahul Verma\u2019s crusade, school-based education programs and public health initiatives are helping limit unhealthy eating, even in adult populations. Rajeev Kakkad says he has seen a \u201csignificant drop in children pestering for junk food, cola, or crackers\u201d due to the education children receive in schools. \u201cCoaching children may have a bigger impact [than taxes or fees],\u201d he says. \u201cFor example, one my friends\u2019 sons doesn\u2019t allow his father to have cola and frowns if his father consumes one.\u201d<\/li>\n<\/ol>\n

     <\/p>\n

    Even though fast food and junk food are growing quickly in India, resulting in increased lifestyle-related disease, the public health fate of India looks to be on a different path than that of the U.S., and hopefully for the better. Most of my family members have already curbed their fast food and junk food consumption based on new knowledge of the link between diet and the onset of Type 2 diabetes and other diet-related diseases. Rajeev, Ushakant, and Bansari all report reducing how much fast food and soda they and their families consume.<\/p>\n

    The irony of it all is that that while many South Asians glorify Western food, American wellness experts are now highlighting South Asian kitchen staples as the ticket to lifelong health. Turmeric and lentils have recently been categorized as \u2018superfoods\u2019 \u00a0in America, but these ingredients have long made daily appearances in most South Asian homes. I grew up drinking \u2018turmeric lattes\u2019 and eating daal. So while some South Asians think that noshing on a burger and fries is \u2018cool,\u2019 perhaps they should reconsider. The ingredients for good health\u2014the coolest thing of all\u2014have been sitting in their pantries all along.<\/p>\n","protected":false},"excerpt":{"rendered":"

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