Ratification of the Paris Agreement on greenhouse emission by India recently was in the news and by this the country, which together with China and the US contribute more than 42% of carbon emission, has clearly committed itself to make conscious efforts to reduce the environmental degradation by suitable ameliorative actions and programs. It may be recalled that the Paris Agreement within the UN Framework Convention on Climate Change (UNFCCC) was aimed at dealing with greenhouse gases mitigation, adaptation and finance starting with the year 2020. 195 countries attending the 21st Conference of the Parties of UNFCCC in Paris on 12 December 2015 adopted by consensus agreement to be signed and ratified within an year. Accordingly 193 countries signed the Agreement on 22 nd April, 2016 in New York. This was followed by ratification of the same by 103 countries by November 4, 2016. A relevant question that was raised subsequent to the agreement was whether it will adversely impact on food security and health of people by taking proactive action on curbing greenhouse emissions through many means available to each country?
It is not that food situation did not escape the notice of the delegates participating in the Paris Conference because food is a highly sensitive issue involving emotional factors and life and death of their citizens. Wisely the Agreement stipulated clearly that, though the aim of the Agreement was to strengthen the global response to climate change, such measures should be taken in a manner that does not threaten food production. But how can this can be done considering that the food production system globally account for more than 30% of the green gas emission each year? According to available data, food production and consumption involve an entire gamut of activities that include fertilizer production, food storage including low temperature warehousing and packaging. Many might not be aware that the field operations involved in food production emit a staggering 12,000 megatons of carbon dioxide equivalent every year while fertilizer industry contributes another 600 megatons. Added to this refrigeration system that is an integral part of the food chain generates about 500 megatons of carbon dioxide equivalent. Agriculture sector includes production of food grains, dairy products, horticulture produce, beef, poultry, mutton and pork.
Looking from another angle what contribution each of the above food categories affect human health? While food grains are considered the most basic food for majority of the population across the world, for good health a mixed diet is a prerequisite. That implies man cannot live on food grains alone requiring in addition nutrient dense foods like meat, poultry, fish, dairy products, fruits, vegetables etc. After all getting 2000 to 2500 kCal alone cannot provide a healthy life and other sources that contribute quality proteins, essential fatty acids, vitamins and minerals and dietary fiber are as important as food grains for maintaining good health. Therefore any food production policy that will have to be dovetailed to the objective of greenhouse gas emission reduction will have to tread carefully in order not to adversely affect food and health security. Within the agricultural sector livestock raising accounts for highest emission and any plan to reduce emission will have to consider bringing down consumption of the products from live stock industry that produces beef, milk, mutton and pork. Is this possible when majority of global population is addicted to these products resisting any attempt to cut consumption of these foods with high carbon foot prints?
While climate changes are definitely affecting adversely the health conditions of humans besides contributing large scale changes in the weather conditions and raising global temperatures across the world, food, both quality and quantity wise is influencing the quality of life and spread of diseases and disorders among the people. This poses a great challenge to the policy makers in orchestrating programmes and actions that strike a balance between climate changes and food production. According to some experts consumption of too much sugar, fat and animal based foods collectively contribute to spread of health afflictions like CVD, diabetes, kidney disorders, obesity and others while in economically poor countries limited availability of protective foods is causing stunted growth and health disorders like Kwashiorkor, Marasmus, Anaemia and other deficiency manifestations. Take the case of meat and meat products which if consumed in moderate quantities along with plant based foods can be expected to maintain normal growth and optimum health, same products when over consumed have opposite effect as is happening in rich countries like USA, Europe, Canada, Australia etc. Naturally any call to limit production of animal foods and their consumption can have a favorable impact on health as well as the environment but same measures will further deteriorate the restricted availability of such nutritious foods in developing and underdeveloped countries. Policy orchestration therefore will have to be dovetailed to the special needs of individual countries depending on their economic prosperity and purchasing power. Probably Paris Agreement has this factor in mind while formulating the final recommendations.
There has been some thinking about use of the economic tools to regulate over consumption of foods with high carbon footprints like meat and milk products. According to this concept there should be a Carbon Tax on high greenhouse gas emitting foods like beef which naturally will raise the consumer price very significantly, similar to the tobacco tax or alcohol tax, hopefully leading to reduced buying in the market place and lesser consumption progressively. Taxation as a disincentive was tried in the food and beverage sector in some countries with mixed results. Most notable is the "soda tax" which was tried out by some countries and while soda consumption did come down to some extent the result was not very significant or sustainable. The tiny state of Kerala in India is now trying out a "sugar tax" which is imposed on all foods containing more than 20% sugar. It is doubtful whether this will succeed to the extent anticipated. Sugar tax and Fat tax were thought of by countries like Denmark but fat tax has been discontinued while sugar tax is still in place. Globally sugar tax is becoming more and more common with countries like the UK, the US, South Africa, Norway, Denmark and France adopting this economic measure to cut down on sugar consumption. It is estimated that making a product 10% costlier can reduce consumption between 5 and 10 % and such a reduction could reduce incidence of diabetes significantly.
According to some research data beef consumption can be brought down if it is made 40% costlier through levying appropriate taxes and making it that much costlier can be expected to change the buying habits of people to depress the market to the extent of at least 13%. Those buying meat twice a week are likely to change their buying mode to once a week. On a global level if such a reduction is achieved, green house gas emission is likely to be reduced to the extent of a billion tons besides saving half a million lives by 2020. Similarly increasing milk prices by 21% is supposed to reduce its consumption by 9%. A 15% costlier mutton can lead to 6% reduced purchase at the market place. If these projections are true developed countries have a ready route to achieve their carbon reduction targets through a taxation regime to make some of the foods implicated in obesity and other life style disorders significantly costlier. Of course this is more easily said than done considering how powerful is the food industry lobbies in these countries which have the eyes and ears of the law makers who have to take these baby steps to bring in sustainable results over a period of time.
Recent gas chamber like situation in Delhi where pollution reached extraordinarily high levels gives a peep into the difficulties India may face in achieving any seizable carbon emission reduction. Though there is a controversy regarding what factors were really responsible for such large build up of PM 10 ( 808 ug/m3) and PM 2.5 (622 ug/m3) in the atmosphere surrounding Delhi, agricultural activities in the states surrounding Delhi has definitely made substantial contribution to the misery of the people in the capital city. Two biggest grain producers in the country Punjab and Haryana lie just west of Delhi and after the harvest season farmers burn the stubbles routinely generating huge smoke that spreads to urban areas near these agricultural fields. No one knows how much pollution is added by this smoke to the prevailing in situ generated pollution caused by diesel vehicles and building industry. Open burning is banned in some states penalizing those who indulge in these practices but like all other laws this rule is widely ignored. Though there are grand announcements by the Central Government that farmers would be provided with better technologies to deal with post harvest residue management, one has to wait and see whether any thing is going to happen immediately.
The debate about the safety of Genetically Modified Organism (GMO) foods never seems to end and in fact it is becoming more and more bitter and acrimonious day by day. The vacillating attitudes of government policy makers regarding making labeling mandatory for foods derived from raw materials raised by genetic modification are making the consumers more and more disturbing leading to world wide campaigns to ban such foods until their safety is established beyond a shadow of doubt. Massive consumer movements and multi pronged initiatives by consumer groups across the world demanding at least forcing the industry to declare on the label presence of GMO ingredients are gaining momentum and it is a question of time before the industry has to bow before such cascading consumer pressure. A simple question as to why the GMO industry is fighting tooth and nail to sabotage plans for making label declaration mandatory is- why are they doing it if GMO foods are absolutely safe? May be industry has a feeling that consumers will boycott such foods if they become aware of presence of GMO ingredients in such products. Added to this many products carrying declaration that they do not contain GMO ingredients provide a ready platform for consumers to go selectively for such "neat" foods as perceived by them, in preference to the GMO containing ones. Ultimately it boils down to the impact this will have on the bottom line of many GMO food peddlers!
Food and Drug Administration (FDA) of USA whose dictats are followed by many countries across the world has been very circumspect in its interpretation and policy orchestration vis-a-vis GMO foods. For ages FDA has been maintaining that GMO foods are "almost" like natural foods and are safe to consume by human beings. Probably such a policy support to the GMO industry has created a situation in that country where more than 80% of the processed food products made and marketed contain one or more GMO ingredients without the innocent consumer ever knowing about it! Does this not amount to deception by a government supposed to be the most democratic in the world? Is this ethical? Of course in an over democratized country like the US every individual has the right to do what he or she wants and true to this "ideal" the elected representatives also practice their fundamental right to say and do what they feel is right. It is another matter that a majority of these law makers are obliged to the GMO lobby because their elections have been bank rolled by them and they feel it is not correct to let their clients down by siding with the citizens though they forget that they owe their power to the very same electorate!
Here is a contradiction which is very difficult to explain away. In some of the states the proposal to make declaration of GMO ingredients mandatory failed ballot initiatives giving an impression that people are not too concerned about this issue. On the other hand surveys after surveys have shown that more than 80% of the citizens want to make such labeling compulsory! This has been attributed to the massive propaganda unleashed by the GMO lobby to "brainwash" the consumers through half "truths" and "no truths" about the safety of GMO foods. To an ordinary citizen it does not make any sense to adopt GMO foods because nature provides foods which have been found safe over centuries and why there should be attempts to tinker with nature. Hybridization technology practiced since long takes time to give desired results but the resultant hybrids generated due to natural gene mutations are stable and safe, consumed since time immemorial. Also not easily understood by the common man is the advantage of GMO foods for them or for the humanity as the claims of increased yield through GMO technology has never been proven any where so far. Of course traits like pest resistance and others are incorporated through GMO technology but here again net advantage is not undisputed.
Why is that the issue of GMO foods became a debating point again? Recent attempts by FDA to stop use of the phrase " does not contain GMO ingredients" by those not using them has created another unwarranted controversy and many feel that such an attempt is tantamount to punishing the citizen through denial of information about the nature of food being purchased by them. FDA feels that no one should use such declaration because many foods created through biotechnological process do not use genetically modified organisms all the times and most products are at best genetically "engineered" or "bioengineered"and therefore industry must shun using GMO word unnecessarily to avoid confusing the consumer. It is similar to saying that "no protein is present in an edible oil pack". May be there is a point and FDA may be right in issuing such an advisory which industry can adopt as long as no one uses the word GMO in any context. As far as consumer is concerned all he is interested is to know whether the food he is buying is made from natural ingredients with proven credentials. Whether the new FDA advisory is acceptable to the industry remains to be seen.
Many major food companies using genetic engineered food ingredients are happy that FDA has stuck to its position that it is not required for the processors to disclose presence of genetically engineered ingredients, sticking to its position that such products are not materially different from non-engineered versions. After all industry's efforts to resist mandatory labeling, fearing that customers will be scared off by foods known to contain genetically engineered ingredients seem to be succeeding. However the specious plea by them that mandatory labeling will drive the cost of the food cannot be accepted. It is a good sign that many major food companies have already moved to voluntarily label products that do not contain genetically engineered ingredients, either simply stating that on their packaging or using a small butterfly seal to show that the Non-GMO Project, a nonprofit that provides certification for food producers, has certified the absence of genetic engineered substances. Interestingly there is a genuine attempt by many manufacturers in the US to source non-GMO. ingredients which is a good sign as far as consumers are concerned. According to a recent report there are more than 30000 products in the US market carrying the label that they are free from GMO food ingredients and probably this sector may be worth about $ 13.5 billion which may be a fraction of the total retailed foods estimated at $ 638 billion last year.
The desire of the citizens for accessing clean and safe foods is reflected by efforts in the US in different states to mandate labeling of foods that do contain genetically engineered ingredients but they have largely failed by narrow margins, after heavy lobbying and campaign spending by the food and biotech industries. it is in this context that the law makers at the federal level passed a bill that would require food companies to reveal presence of genetically engineered ingredient in food products via a QR code, a pixelated square that can be scanned with a smartphone, on packaging that will reduce the chorus for hard printing the same on every label. Though it may be acceptable to many people who have adequate computing literacy to read the code before making a buying decision, a vast majority might not be able to decode to understand the nature of the product. In such a situation FDA also wants to differentiate between genetically engineered and genetically modified to convey different things to the consumers. According to them genetically engineered product comes from the efforts of biotechnologists originating in a laboratory while genetic modification happens by natural process as in hybridization process. Thus we have three technical terms which include Genetically Modified Organism (GMO), Genetically Engineered (GE) and Genetically Modified (GM). Of the three GMO is the most dreaded because genes from another species find their way into a particular food, though in small quantities. This means GM foods are analogous to natural foods while GE foods are similar but created in the lab with some distinct advantages.
Consumer is still left confused to make out what each of this term means if industry starts using all three terms for declaring their products are free from them. Probably more positive approach could be to make those using food ingredients created through GE or GMO technology to declare the same unequivocally as a part of the transparency protocol which consumers are bound to appreciate. Whether industry will agree for such a transparent practice is some what uncertain at this point of time because of monetary implications. Efforts of many manufacturers to source raw materials not tainted by GE or GMO will get rewarded only if declaration of presence or absence of lab created food ingredients on the label of each pack..
We all know that food serves the twin purpose of satisfying our hunger and delivering the nutrients we need for growth and well being. Out of the three basic necessities of life, viz food, shelter and clothing the first one is most important as without food along with air and water no life can sustain in this planet. Most human beings take it for granted that when food is consumed the gastrointestinal ( GI )system automatically process these foods into usable nutrients required for the well being. But rarely any thought is given as to how complex is the GI system and what problems can arise if the normal process of digestion and absorption is hindered or adversely affected due to a host of reasons, many of them not still well known. Only people with disorders like allergies, intolerances, Crohn's disease, Celiac disease, Irritable bowel syndrome etc know what sufferings they have to endure as the present day treatment regimes are not considered absolutely satisfactory. Explosive growth of that industry sector manufacturing gluten free foods bears out the fact that all foods cannot agree with all the people. The so called well being food industry is rolling in money because the products being made by it commands a good following by those with one or the other real or imaginary problem with the foods they eat. Recent evolution of the concept of adverse effect of FODMAPS, a group of carbohydrates present in many foods, is further complicating the picture vis-a-vis tolerance of some of the foods by the GI system. Whether this is really a significant issue will emerge soon requiring attention at the hands of health pundits sooner or later.
Take the case of Gluten-free foods which are made and marketed through out world mainly to cater to the needs of those consumers who experience disorders like Irritable Bowel Syndrome (IBS) and Celiac disease. These foods are designed based on the presumption that gluten is primarily responsible for the discomfort experienced by the patients. However over the years many consumers who do not have this disorder, rightly or wrongly, seemed to have started a feeling that gluten is a villainous food component and avoiding the same can improve their quality of life.The result was the beginning of a booming industry that caught the fancy of the consumer creating a huge market. Whether it is ethical for this industry to make a fast buck exploiting the misconception that is gaining traction during the last one decade is a difficult issue to answer because the industry is after all giving to the consumer what he wants on a platter. What may not be justified is the massive marketing blitz singing the virtues of gluten free foods attracting more and more consumers of normal health into the fold of IBS patients. The global business for gluten free foods is reported to be worth $ 3 billion which is predicted to reach about $ 5 billion within 5 years. Interestingly Europe leads in marketing these foods, more than 50% of business generated in this region. But in terms of growth, USA is on a fast galloping growth phase out pacing Europe in the near future though no one knows what is contributing to this peculiar phenomenon.
Though no reliable statistics can be cited for the extent of people affected by intestinal disorders like IBS and Celiac disease, some estimates claim that 10-15% of global population is affected. But among those patronizing gluten free foods more than 70% are not suffering from this affliction. That means the size of the current market does not reflect the ground reality vis-a-vis gluten induced GI disorders. While gluten free food market is fast growing, there is another interesting development that gives further hope to the well being industry to expand the market several fold. Based on the findings in Australia that besides gluten, there is a range of food constituents present naturally in most foods which can also create GI related disorders. These are collectively called FODMAPS, the acronym for Fermentable, Oligo-, Di--Mono-saccharides and polyols and it has been scientifically shown that reducing the levels of FODMAPS containing foods in the diet dramatically provides relief to those suffering from such GI related disorders. What does this mean to the food industry? A sign that demand for specially designed food products containing no or low levels of FODMAPS is bound to grow dramatically in the coming years.
Though Gluten cornered all the attention over many years as a causative factor for GI disorders, there have been many observations in the past that consumption of some carbohydrates does not go well with many consumers and among them a few short-chain carbohydrates that include lactose, fructose and sorbitol, fructans and galacto oligosaccharides caused IBS-like symptoms. What was more significant was that such studies also showed dramatic improvements among the affected people when there was dietary restriction to exclude short-chain carbohydrates in the diet. These carbohydrates induced symptoms similar to that caused by Gluten in the small intestine. These short-chain carbohydrates, being small molecules are either poorly absorbed or not absorbed at all and are capable of dragging water into the intestine through osmosis Further they are easily fermented by colonic bacteria that reside in the large intestine generating gases like hydrogen, carbon dioxide and methane. Such a situation causes an expansion in volume of intestinal contents, which stretches the intestinal wall and stimulates nerves in the gut. that triggers the sensations of pain and discomfort, commonly experienced by those affected by IBS. The FODMAP concept maintains that a collective reduction in the dietary intake of all indigestible or slowly absorbed, short-chain carbohydrates would minimise stretching of the intestinal wall which in turn may reduce stimulation of the gut's nervous system and provide the best chance of reducing symptom generation in people with IBS. Later the collective term FODMAPS was evolved for designating indigestible or slowly absorbed, short-chain carbohydrates.
Formulation of low FODMAP diet was originally developed by scientists in Australia and tested as to know whether low FODMAP diet really improved symptom control in patients with IBS. It is this pioneering work which established the mechanism by which the diet exerted its effect. This led to efforts to evolve methodologies for measuring the FODMAPS content in foods and create a data base for foods that are consumed regularly. It is tribute to these scientists that a comprehensive and accurate database now exists describing the FODMAP content of a vast array of foods. There is now a better understanding about the mechanism by which the diet works and there is sound evidence indicating that a low FODMAP diet improves symptom control in approximately three out of every four people with IBS and other other Functional Gastric Intestinal Disorders (FGID). To day it is more or less agreed that the basis of many functional gastrointestinal disorders (FGIDs) is distension of the intestinal lumen. Such luminal distension may induce pain, a sensation of bloating, abdominal distension and motility disorders. Therapeutic approaches seek to reduce factors that lead to distension, particularly of the distal small and proximal large intestine. Food substances that can induce distension are those that are poorly absorbed in the proximal small intestine, osmotically active, and fermented by intestinal bacteria with hydrogen.
An important question that may trouble many consumers is whether poor absorption of most FODMAP carbohydrates present in many foods can affect every body including normal healthy persons. A pertinent question that can be explained away in an understandable language. Any FODMAPs that are not absorbed in the small intestine pass into the large intestine, where bacteria ferment them. The resultant production of gas potentially results in bloating and flatulence. Fortunately most individuals do not suffer significant symptoms but some may suffer the symptoms of IBS depending on their constitution and other biological variations. Fructose
malabsorption and lactose intolerance may produce IBS symptoms through the same mechanism but, unlike with other FODMAPs, poor absorption is found only in a minority of people. Many who
benefit from a low FODMAP diet need not restrict fructose or lactose. It is possible to distinguish these two conditions by breath testing for the presence of hydrogen hydrogen and methane breath which will help to build into the diet only reasonable restrictions. Some of the significant sources of FODMAPS include wheat, rye, barley, onion, garlic, jerusalem & globe artichokes, asparagus, beetroot, chicory, dandelion leaves, leek, broccoli, brussel sprouts, cabbage, fennel etc. Pulses and beans are rich in galactans while some some fruits like apples, apricots, avocado, blackberries, cherries, lychees, nectarines peaches, pears, prunes, water melon have significant concentrations of polyols. Isomalt, maltitol, mannitol, sorbitol and xylitol gets into the food when they are used as functional processing adjuncts by the industry. If such a large portfolio of foods is out of bounds for some people vulnerable to GI system malfunctioning, it is difficult to imagine how their quality of life is affected. May be this is the price humans pay for the progress of civilization as we see to it day. Ultimately the one going to be benefited is the well being food industry and the pharma sector!
When it comes to research and development efforts, especially those with potential commercial application, who funds them becomes critical if the results of such scientific studies are to be credible. This is the reason why public funded research assumes critical importance for protecting the health of the citizen. In a country like the US, industry is in the forefront to offer financial assistance to Universities and other R & D institutions, the obvious purpose being touted as public interest. In contrast a country like India where resources are limited and industry is reluctant to open their purse for research in public organizations, most research is funded by the government. Is it not an irony that results generated by public funded agencies are not taken seriously by the industry due to many reasons while industry sponsored projects try to ensure that there is veil of secrecy attached to them for gaining advantage vis-a-vis the competitors. Thus renowned institutions in India like CFTRI, DFRL, NISTEM and a host of universities engaged in food R & D are repositories of knowledge generated over decades of research spending huge public money. Which system is preferable for the progress of a country is indeed a vexed question with uncertain answers.
The above issue came into sharp focus after a recent report about the unethical practices perpetrated by the sugar industry in the US to mislead the government as well as the consumers through "sponsored" research in some organizations using "friendly" scientists to deflect the truth that sugar is responsible for almost all the ills faced by the American citizens during the last 50 years. Words like Cardiac disease, diabetes, cancer, hypertension, kidney impairment etc are magnetic words that command immediate attention by people who are concerned about the terrible health disaster looming ahead of them and how each one of them can avoid succumbing to these ailments. It is in such an environment that sugar industry sponsored and funded research sought to assure the citizens that there is nothing wrong with consuming sugar and the real culprits are saturated fats, cholesterol and lack of physical exercise. Even if they have a point in asserting about other factors, it is is nothing but fraud to suppress the results that showed adverse impact of sugar on health and continue to pump into the market products with high levels of sugar that stimulate the taste buds of most citizens. If sugar is so innocuous why is that the whole world is now trying to curb its consumption through persuasive as well as mandatory actions to force the food industry to reduce sugar levels in their products? Such research projects are more aptly called tailor-made research to suit the needs of the sponsorer rather than a genuine scientific research!
One is reminded of the famous quotes of the CEO of the biggest soda company in the world where in consumers were advised not to bother about sugar in the soda but concentrate on physical exercise for maintaining their body weights. That shows the mindset of the food and beverage industry which has least priority as far as the health of the citizen is concerned or the quality of the environment he lives. Though the sugar industry tried to portray sugar as a safe ingredient through its tainted research efforts, it is now universally recognized that sugar is an addictive substance like opioids and habit forming and once hooked on it is next to impossible to keep away from sugar sweetened products. On the economic side down fall of sugar from its high pedestal can have severe financial impact on industries based on beverages, confectionery including chocolates, fruit preserves, canned fruit products and pastry products. Is it not a catch 24 situation? One cannot demolish the industry which provides gainful employment to millions of people while it is criminal to ignore the harmful effects, if any, of the products the industry churns out? That is probably the logic behind the approach of governments like that in the US not to be too harsh on the industry but use persuasive efforts rather than coercive methods to ensure healthy products are made in stead of suspect products too high in sugar, fat and refined carbohydrates.
Sponsored research generally refers to programs funded by private players among the industry to achieve a certain result of their liking but what is nauseating is the tendency of the funding party to influence the results and bring out results that suit them. The sugar research mentioned above comes under this category. There are many other instances where such studies have been financially supported by the industry and obtained results that help to market their products among the unsuspecting consumers. An excellent example is the research sponsored by the cocoa industry to implant in the minds of the consumers that chocolates are healthy because it is supposed to contain antioxidants like flavanols. Sadly this is a red herring because the harsh processing conditions undergone by cocoa beans before they become suitable for making good quality chocolates do not help to retain much of the flavanols in the final product. On the contrary chocolates are rich in saturated fats and high in sugar making them a prime candidate as a causative substance for some of the life style diseases encountered to day. Even the new generation healthy chocolates now in the market containing upwards of 70% cocoa solids are suspect products with no proven health benefits. Imagine how this industry making obviously a unhealthy product is flourishing raking up billions of dollars of business all over the world! Probably most of the so called well being products in the market to day have not undergone any sound scientific studies with hardly any credible peer review.
In a world starved of funds for research which after all cannot bring dividends in the short term, can the scientists refuse funding from the industry? Of course not. There must be some ethical standards which have to be followed while accepting such funding. Who will set such standards? This is the duty of the research organization in collaboration with the government. While product development may be a genuine area for industry funding, especially in a country like India where captive research set ups are far and few because the astronomical cost involved in establishing them, the R & D agencies must be careful regarding projects offered by the industry to support their unjustifiable health claims and far fetched agenda. India is fortunate in having organizations like CSIR, ICAR and ICMR with a vast network of R & D laboratories with a massive number of multidisciplinary scientists and all claims made by the industry must be verified before allowing to be marketed and if there is a resource crunch those who make the claim can be charged, at least nominally so that consumers can trust such claims when printed on the label.
Coming to cooked up research, many of the studies undertaken by scientists and degree yearning research scholars are suspect as they do not face any real test regarding the veracity of their results. Those pursuing doctoral degrees are aware that no system exists to day that can challenge their results through repeating their studies to confirm the same! This is not to brush the entire research system with tar but to highlight the lacunae of the present university research system. There may be many honest scientists with unimpeachable integrity and honesty but they are far and few in to day's permissive atmosphere where every thing is accepted as truth without undergoing the veracity check. Internationally there have been many instances where research findings are retracted after a few years of their publication, more by accident than by any genuine checking system. If some of the R & D agencies working under government aegis have miserably failed the nation in delivering what is expected from them through development of global standard technologies, lack of reliability, trust of the potential users and failure to demonstrate under field conditions are responsible. One has to admire our scientists in space agency who cannot afford to fudge results because to ensure success of the space program their work has to be demonstrable and reliable for the entire country to see. It is this golden standard scientists in other fields also must set for themselves if they do not want to loose their esteem before the public.
Diabetes is by now considered a debilitating disease which many viewing it as a silent killer. While educated people with some basic knowledge about the etiology of this affliction understand how the food we eat affects the blood glucose level and the adverse effect high glucose levels can have on different health parameters. It is sad to see millions of people suffering from diabetes, not very much aware of the consequences of eating high carbohydrate foods, that too based on highly refined ones, on the dynamics of glucose generation within the body and fall prey to serious ailments affecting eyes, heart, kidneys, limbs etc destroying the quality of their life. According to available reports there are more than 422 million people suffering from this disorder which is fast becoming a top killer among all the diseases. In India itself number of people afflicted by diabetes is placed around 62 million and if experts are to be believed, India may become the world capital of diabetes soon, if not checked effectively. Once diabetes is diagnosed appropriate diet and disciplined eating habits can provide substantial benefits along with correct drugs in right dosage. Inability of the body to assimilate sugar at a rate that will prevent undue build up in the blood, due to insulin insufficiency or insulin insensitivity has to be recognized and such build up can be "managed" only by a diet predominant in whole grains with particular emphasis on pulses, vegetables, meat, fish and nuts with low rate glucose release when consumed.
It is not that information is lacking regarding the type of foods that can be eaten moderately and the quantity that can be safe but often the logistical difficulties in adhering to a strict diet regimen besides often conflicting nature of such information, make it impractical to follow the guidelines of the physicians. Against such a situation the evolution of the concepts of Glycemic Index (GI) and glycemic load (GL) during early eighties provided a reasonably reliable guide to the ability of different foods consumed regularly to generate glucose in the body. Thus high GI, medium GI and low GI foods were developed or conceptualized that will safeguard against undue glucose spikes in the blood after consumption. But if recent reports by a group of scientists from the US are to be believed, GI is not as reliable as it was thought to be pushing millions of diabetics as well as the food industry developing products with low GI into a new era of uncertainty. What are the implications of the results of this study?
Traditionally blood glucose levels, estimated after a 12 hour fasting and 2 hours after ingesting a normal breakfast provided a reasonable clue as whether a person is diabetic or not. While a glucose level of 100 mg per 100 ml after fasting and 150 mg/100 ml 2 hours after breakfast are considered normal. Though there are slight variations in diabetic assessment technique essentially all of them highlight the ability of the body cells to assimilate free glucose from the blood for hundreds of biological functions. While high levels of blood glucose are supposed to cause hyperglycemic conditions considered dangerous, especially it it continues for long time, low levels of glucose cause hypoglycemic symptoms such as giddiness and over all weakness. Though these values are more or less accepted universally, monitoring blood glucose levels frequently, especially in the home environment is fraught with some logistical problems. Estimating glucose in a pathological laboratory may take at least a couple of hours but there are home gadgets based on mild pricking and drawing a tiny drop of blood on to a glucose oxidase enzyme strip that provides digital readings of glucose levels in a matter of a few seconds. Many people buy these gadgets for testing of glucose as and when they feel symptoms of hyper or hypo glycemia. A non-invasive system without the necessity of puncturing the skin is still in the realm of development and may take some time before becoming a common tool.
What is GI? Using a standard material like sugar for testing glucose transfer to blood from the food ingested is measured as a percentage of the time taken for the sugar to manifest in the blood, GI is expressed usually as a definitive number. Easily assimilable and fast appearance of glucose from the ingested sugar sources usually have high GI numbers while those foods which do not release glucose easily have low GI values. Generally whole grains and pulses are slow glucose releasers and hence have low GI values. Most food products based on sugar and refined cereal flours have high GI values indicating that they cause glucose spikes in blood considered highly undesirable. Similarly processed foods containing high levels of retrograded starch and uncooked foods also have relatively lower GI values. Since a diabetic wants to avoid rapid rise in blood sugar levels, his choice is always foods with low GI numbers. Food industry also strives to evolve food products with less and less GI numbers to attract diabetes affected consumers and incidentally such tailor made foods also command higher prices.
It is almost a decade and a half since GI became a standard parameter for assessing suitability of different foods for consumption by diabetic affected people and no one has so far contested the relevance or reliability of GI to assess the glucose release and absorption by the blood. Of course from time to time there were informed criticism regarding the reliability of GI concept, in the absence of a better alternative, GI was still widely adopted by nutritionists and medical community as a practical tool. Though GI is widely used by physicians and dietitians for advising their clients regarding the best foods they must consume to control diabetes, periodic checking of fasting sugar and postprandial sugar levels still gives an idea about the extent of control of the food regimen by a diabetic patient. Of course this traditional practice of glucose monitoring in the morning can at best give a picture about the glucose dynamics in the blood during pre-lunch period. What about the situation in the post lunch period? Though many diabetics use home gadgets to monitor the blood glucose level as many times as they wish, it is not practical to do this often due to the physical discomfort involved in skin puncturing. The concept of glycosylated haemoglobin (HbA1c) measurement in the blood once in 2-3 months provides a reliable means of knowing about the history of food eating during that period. While a value of less than 6 is considered normal, any value beyond that can be an indicator of onset of diabetes. Values beyond 7 must be taken seriously to exercise better control of the diet by including more and more of low GI foods in their diet.
One can realize how far the world has gone in adopting GI as a useful tool to manage diets. It is this edifice which is sought to be destroyed by the findings of a group of scientists in the US who claim that GI is not as dependable as it is thought to be, because of inconsistent values of GI noted for the same food in different people. While minor variations up to 5% can be ignored because of experimental error that may creep in in different laboratories, variations as big as 20% cannot be attributed to lab error. If their results are true the commonly consumed white bread can show GI values ranging from 47 to 77! This means white bread can be a low GI food for some, medium GI food for some body else and a high GI food for some others. How ludicrous it is? But if the results of the American scientists are validated, it is going to open a Pandora's Box with unimaginable consequences. Low GI foods have values 35-55, medium ones 57-67 and high GI category with GI 70-103. More shocking is that same food with a certain standard GI value gave widely different values in the same person when determined on different occasions according to these scientists! What can one make out of these observations and what impact it will have on various stakeholders of the diabetic disease?.
It is unfortunate that the new studies have come at a time when some consensus is emerging about the need for the food industry to include in the label information regarding the GI value of the contents within the packet. Will this be the pretext for the manufacturers to resist pressure from the consumer community to publish GI data on the label? That should not be allowed to happen at any cost unless more studies are organized to validate the new findings. Even if GI values show variations under different conditions, by and large they seem to remain same most of the time. Similarly it does not matter that GI response varies from person to person since most data applied to day is based on majority response. Till a new and better alternative energies, it may be fool hardy to ignore it for the time being. Diabetics are better advised to base their diet on low GI foods and best way to manage diabetes could be to adopt diets based on foods undergoing minimum processing.
The million dollar question is whether hundreds of scientist working on GI of foods have gone wrong some where? What can be the scientific explanation for this shocking anomaly? A larger question is if there are such wide metabolic and physiological variations amongst human beings, what relevance studies using humans as subjects can have in generalizing the results of such studies to be applicable to entire humanity? This question assumes more significance when human studies are undertaken while testing drugs for various ailments and diseases. It is urgent that the questions raised by the Tuft university scientists are further examined by a few independent groups under international collaboration to arrive at a consensus. If Gi tool is to be thrown out of the window what other alternatives we have to assess appropriateness and soundness of foods for consumption by diabetic population? No body disagrees with the universal consensus that fruits, vegetables, whole cereals, pulses and foods rich in retrograded starch must constitute the core part of any diet but to make them palatable appropriate products have to be evolved acceptable to the targeted consumers. .