Banning sale of of Junk foods near schools-Is any one serious?

In India if no decision is to be taken on any issue, especially at government level, the most effectively used strategy is to "set up" a committee which guarantees that the issue is buried at least for some time! Most recent case is the "decision" by the Women and Child Development Ministry of Government of India (GOI) to "consider" banning junk foods near schools constitutes an excellent one to illustrate this point. It was about 5 years ago that Uday Foundation, an NGO approached Delhi High Court (D-HC) pleading to impose a ban on sale of junk foods near schools where kids, with pocketful of money liberally provided by parents, buy unhealthy foods affecting their health in the long run. It was indeed a noble effort by this Foundation to help the nation to protect its budding citizens from the harmful effects of so called junk foods and they deserve our gratitude for this visionary move.to focus attention on this much neglected area. Looking back the D-HC, progressive as it is, allowed the appeal in December 2010, asking the central government to respond suitably to address this issue.

What is a junk food? Unfortunately there is no consensus on this much debated subject though food industry considers all the products manufactured by it are foods providing at least calories and/or proteins and/or other nutrients required by human beings. They further aver that the products made by it are as per safety norms prescribed by the appropriate authorities vested with strong powers. May be the industry has a point in that all foods which conform to national quality and safety norms are edible and serve the purpose of satiating hunger. Besides the industry is selling products which are accepted by the consumers on their own volition with no compulsion or external pressure. Implications of fat, that too saturated fats, in many life style diseases like CVD, obesity, blood pressure etc and unveiling the role of dietary fiber in diseases related to gastrointestinal tract created a great awareness about the importance of balanced foods and physical exercise leading to the campaign by consumers and consumer organizations against the food industry to change the product portfolio to shun products which according to them are unhealthy. It is generally understood that consuming regularly foods with "empty" calories (nil or low nutrient density) is not good for health and this can severely affect growing children in terms of starving them of vitally needed nutrients at the most critical stage of their development. That is how the junki food concept arose originally in wealthy countries like the US where more than 35% of the population is considered obese as measured by the Body Mass Index (BMI) yardstick.

Whether it is the desire to ape the West or due to genuine concern, in India also the issue regarding junk foods was raised from time to time with neither the social organizations nor the government giving serious attention. Though a segment of the consumer community was worried about the long term impact of not restraining food industry to churn out unhealthy foods, targeted especially at the most vulnerable group of children. The topicality of the subject can be gauged by the fact that even to day many countries are finding it difficult to address this problem with total satisfaction to all the stakeholders. The problem became acute with the explosive growth of electronic media and kids became more vulnerable to commercial advertisements promoting these so called junk foods and to add to this the proportion of the commercials to the actual content of the programs is continuously increasing. Unfortunately many parents find it difficult to resist demands by their wards to buy these patently unhealthy food products which do provide fantastic eating pleasure making it addictive. Foods which are so appealing and irresistible are invariably rich in sugar, fat or salt while healthy foods with low levels of these ingredients, rich in fiber are unappealing to most of them. It is conceded that promoting eating of fruits or vegetables in place of fried or baked snacks is a near impossible task.   

Though scores of seminars and workshops have been organized from time to time to discuss this issue, nothing concrete emerged during the last 3 decades. It was left to a young voluntary organization, Uday Foundation devoted to helping promote the cause of distressed children to rake up this issue in the year 2010 approaching D-HC which resulted in the directive given by D-HC to the Central Government to ban junk foods near the vicinity of schools. After debating the issue for almost 2 years , the court issued another order in Jan 2012 asking the Health Ministry to take action to ban sale of junk foods within 6 months. Shamelessly the GOI after sitting on the issue for almost 8 months, "informed" the court that the task of laying down guidelines had been entrusted to its toothless agency pompously called Food Safety and Standards Authority of India (FSSAI). Nothing happened till April 2013 till D-HC gave another 3 months for GOI to complete the work by July 2013. In Sept 2013 the Court again asked GOI to put in place necessary guidelines for banning junk food sale near schools. Still nothing happened and to add to the delay the industry filed objection to any such ban in Oct 2013 which was over ruled by D-HC. It is against this background that GOI set up an expert group in March 2014 to consider the issue. Alas this group only"recommended" regulation of sale of junk foods. Subsequently another expert committee deliberated the issue and came up with some guidelines in August 2015.    

This high-level committee set up by the Women & Child Welfare Ministry suggested to impose a ban by street vendors within 200 meters of a school. It also wanted the civic authorities not to issue licences to shops and restaurants selling food to uniformed children within 200 meters of a school. Unfortunately the onus of determining what constitutes a junk food was put back to the GOI. It wanted GOI to decide about a comprehensive definition of junk food in the context of children. It is reported to have further suggested that a list should be drawn of "desirable" food items to be offered in school canteens as well as labelling of pre-packaged food, stating clearly as "unfit" for infant/children/pregnant and lactating mothers or persons with specific ailments".  It further claimed that it reviewed the prevalent practices of regulation of junk food in 23 countries and suggested establishment and management of school canteens besides bringing about comprehensive advertisement/promotion campaign to be undertaken jointly by different stakeholder Ministries. The Ministry had constituted the committee under the Chairmanship of Director, National Institute of Nutrition, Hyderabad, to look into matters relating to availability of junk food at various places accessible to children.The committee included representatives from Niti Aayog, Ministry of Health and Family Welfare, Department of AYUSH, Ministry of Human Resource Development, Bureau of Indian Standards, food regulator FSSAI, National Institute of Public Cooperation & Child Development, Indian Council of Medical Research and independent experts in the field of nutrition and clinical psychology/behavioural science.

Now there is some thing to go on regarding this issue, but it is not clear how long the GOI will take to legislate on this important issue. One must remember that India does not lack laws with teeth on the statute books but the country fails miserably in administering these laws to achieve the intended purpose. Whether it is lack of funds or lack of seriousness, it is difficult to understand. It is understandable that being a federal governing system, GOI has to depend on local authorities to implement national regulations and in this case also passing legislation to ban junk foods is not going to help unless adequate monitoring system is put in place to enforce its provisions. Probably putting in place a ban on sale of junk foods may be a beginning which will at least deter a few vendors from selling them near the schools. Ultimately an acute awareness about the dangers of junk foods among the kids as well as the school authorities can contribute much to eradicate this evil. 

V.H.POTTY
http://vhpotty.blogspot.com
http://foodtechupdates.blogspot.com

GUT BACTERIA-WILL THEY HELP ATTACK OBESITY EPIDEMIC?

How desperate people can be when all measures to control body weight come to naught and drastic approaches like bariatric surgery become the most practical step. However such strategies cannot be a standard solution to the problems of millions of people who are confronted by the weight gain syndrome. It is true that the basic scientific foundation for explaining body weight gain is the excess intake of calories through carbohydrates and fats in the diet that become fat deposits in different parts of the body causing weight gain. Balancing of the diet with regard to calories is a prerequisite for avoiding weight gain.

The million dollar question is how to balance the diet vis-a-vis calories? Unless one is aware of the calorie expenditure through physical activity it is next to impossible to decide what and how much to eat. Though a 2000 calories diet is recommended for a healthy normal human, it can be insufficient if the physical activity is too high as encountered by athletes and others doing heavy work. On the other hand a sedentary person with minimum physical activity does not need that much calories through the daily diet. While obesity is an ugly disease with the person suffering from it presenting a grotesque picture and bloated body cynosure of all eyes in public places! While physical appearance is one undesirable feature of obesity, much more crucial is the vulnerability of these unfortunate victims to serious diseases like heart attack, stroke, diabetes, kidney disorders etc.

The Body Mass Index (BMI) is supposed to tell whether one is obese or not and generally any figure beyond 30 is considered dangerous while BMI in the range 20-25 is desirable. There can be many contradictions in putting obesity on a BMI scale with some persons having normal health even when BMI exceeds 25 while some low BMI individuals do suffer from many diseases like diabetes and heart ailments, obviously due to reasons other than high body weight. Though there is a general belief that food intake and exercise can minimize the chances of obesity there can be other reasons for individuals to get high BMI in spite of low calorie diet and regular exercise. Unfortunately the current understanding of this area of human science is not complete and with each passing day new information is emerging regarding the various factors that play different roles in causing obesity.

It was quite recently that scientists discovered about the role of gut bacteria in human health and hundreds of studies have brought about the fact that bacteria in general and intestinal bacteria in particular play an important role in maintaining good health. The fact that new born babies with practically a sterile intestine acquire rapidly a host of bacteria through mother's milk indicating that even different bacteria residing in different parts of the body of a human being play decisive roles in protecting the person as a natural defense and use of chemicals and other antibacterial materials used liberally for keeping away disease causing pathogens can be, in reality, a foolish thing to do in the long run! No one knows precisely how much damage such sanitizing agents can cause to disturb the equilibrium that exists among different species of bacteria that colonize human body.

"Fecal transplant" which has become a standard treatment regime for patients suffering from incurable diseases like Crohn's diseas, Irritable bowel syndrome and others is a telling commentary on the usefulness of bacteria in providing relief to human beings from serious diseases. Though it may sound repulsive to think about transferring feces from one person to another one,  the success of this approach has been so dramatic that thousands of people are becoming candidates for fecal transplant every year all over the world. What is not clearly understood is the identity of the particular species or combinations of them that is providing the relief to the recipients and how long it will take to come out with an answer is any body's guess. But dramatic break through can be expected in the foreseeable future in this critical area.                      

Recent studies focusing on the likely role of gut bacteria on development of obesity are no less dramatic in unfolding another dimension to the beneficiary role played by bugs. in what is considered a solid evidence researchers used pairs of human twins in which one was obese and the other lean. On transfer of gut bacteria from these twins into mice revealed some startling facts which may have long term implications on obesity research. The mice with bacteria from fat twins grew fat while those that received bacteria from lean twins stayed lean! (those that got bacteria from lean twins stayed lean). It is just an empirical observation which needs to be interpreted carefully without drawing any definitive conclusion. With these studies it does not become logical for obese people to become right candidates for fecal transplant. Unless scientists are able to isolate most important bacterial species present in the feces which are responsible for the effect, the scientific theory behind such treatments cannot be unraveled.

What is not to be forgotten is that human biology is so complex it is difficult to pin point what all factors contribute to the phenomenon of obesity. These include genetics, diets and living styles followed by different people. Interestingly it has been shown that with the right diet it should be possible to  change the bacteria in a fat person's gut so that they promote leanness rather than obesity. Further in the presence of a low-fat diet, bacteria from a lean twin can take over the gut of a mouse that already had bacteria from a fat twin causing significant weight loss in the latter but the opposite does not happen and no matter what the diet, bacteria from a fat mouse do not take over in a mouse that is thin. It really adds up to a quiet riddle which needs some unraveling by the scientific community.

V.H.POTTY
http://vhpotty.blogspot.com/
http://foodtechupdates.blogspot.com

CALORIE RESTRICTED DIETS-LONGEVITY CLAIMS UNDER CLOUD

Who does not want to look lean and strong and besides the cosmetic value a good personality radiates, lean body mass is a scientifically proven route to keep good health. While following a strictly balanced daily diet is the surest way to good health, as in many cases of human life, such disciplined eating is more easily talked about rather than being followed! This human weakness for good tasting food with irresistible  flavor and texture credentials is being exploited by many industry players with utter disdain for consumer well being. There are a number of preachers for weight reduction like Atkins, South Beach, Portion Planners etc and billions of dollars of business is riding on this area of health management. How far they are able to substitute human determination and self exercised will power is a mute point as long as there are willing consumers to believe in such unnatural means of achieving weight reduction as quickly as possible.

One of the earliest theories which was floated to achieve longevity and good health was practicing a diet low in calories, much lower than what is recommended, which is supposed to control the body metabolism for preventing fat accumulation responsible for weight increase over a period of time. It was in 1934 that Restricted Calorie (CR) diet theory sprouted in Cornell University, USA based on demonstrable effect of such a diet in extending the life span 100% in rats under laboratory conditions. Since then hundreds of studies in different parts of the world did show that reducing calories in daily diets to the extent of 10-25% could prevent undue weight gain in many animal models. It has been claimed by these studies that such diets are successful in controlling blood pressure, fasting glucose, fasting insulin, BMI, body fat percentage, C-reactive proteins, carotid IMT, Platelet derived growth factor AB and boosting memory status among the animals studied.

An indication about calorie restriction effect was obtained during early studies with yeast, fish, rodents and dogs and such CR diet regimen without causing micro nutrient deficiency was shown to increase both median and maximum life span among the animals studied. Though these results were taken as proof of the scientific basis for confirming the effectiveness of CR diets and promoted for human beings also without adequate mammalian or human studies, there has never been a "sufficiently powered" long term randomized clinical trials of CR in humans to confirm or deny its efficacy in achieving what has been seen in animals. The longest running scientific study of CR in primates has been undertaken in University of Wisconsin and is going on since 1989 without coming to any definitive conclusions regarding the success of CR diet universally.    

CR diet intervention and its usefulness in prolonging life became a focal point of attention recently when National Institute of Health came out with some startling news based on studies in its Institute of Aging (NIA) that CR diets might not be as effective as being claimed during the last several years. After 25 years of observations, it came out that rhesus monkeys fed only a lower-calorie diet lived no longer than their rhesus mates who ate a little more and weighed a little more. This is in stark contrast to what was reported earlier from a slightly different study led by investigators in Wisconsin. which found healthier life for their group of starving monkeys. The NIA study was of a blow to many enthusiasts who whole heartedly welcomed the idea proving that "less equals more when it comes to eating"!. Unfortunately this finding may have the consequences of nullifying the mindset among many consumers that self restraint, continence, and composure in controlling one's appetite pays off in the long run. But the jury is still out on this issue and a closer look at the results may suggest it's not time to indulge in foods ad libitum just yet.

A critical question that may haunt weight watchers and "long life' lovers is whether the new information will allow one to eat a bad, sugary diet, provided too much of it is not eaten. The simple fact is that if one eats more of such foods without control, death is likely to visit sooner than later!. However if good food in terms of balanced nutrition with low sugar, salt and fat using more of whole grains, it may not matter even if more is eaten. In terms of longevity whether CR diet or rich diet, life span may be same though those in the latter category, eating more will still live long albeit weighed down by diabetes and other medical conditions. At least that is the current take on this interesting issue!

V.H.POTTY
http://vhpotty.blogspot.com/
http://foodtechupdates.blogspot.com

"ABSI"-A NEW TOOL FOR ASSESSING HEALTH

Body Mass Index, better known as BMI world over, is supposed to be a marker for considering whether a person is healthy, over weight or obese and this has stood the test of time for decades without seriously being challenged by any other more appropriate body health monitor. BMI was first suggested by Adolph Quetelet, the reputed Belgian mathematician of nineteenth century, around the year 1832, for comparing the health conditions of people based on the body parameters, height and weight and it was known as Quetelet Index or QI. As it became the golden standard since then, the only change that was seen subsequently was changing the name to Body Mass Index in 1972 to make it more explicit and reflect its relation to human health. There are some variants of this evolved later like Fat Free Mass Index (FFMI) and Fat Mass Index (FMI) which take into consideration the influence of body fat in distorting the BMI values. In spite of all these developments BMI is still the universally adopted testing protocol for body weight related problems in populations around the world.

BMI is the ratio of the body weight to the square of height of a person and both Metric and British measuring units can be used to arrive at the figure. For example a person with a weight of 75 kg and height of 1.7 meter is deemed to have a BMI equal to 75 divided by square of 1.7 which comes to 28.9. If British units are used it must be weight in pounds divided by square of height in inches. According to present norms a BMI figure between 18.5 and 25 is considered optimal and if the same is outside this range remedial steps are called for to correct it through appropriate measures. While BMI less than 18.5 is considered to represent underweight, any value above 25 is not taken as normal. In to days world when the number of obese people is increasing at a phenomenal pace through out the world, especially among populations in affluent countries, values of BMI are very relevant to assess the healthiness of people. BMI values 25-30 represent over weight, 30-35 moderately obese (Class I), 35-40 severely obese (Class II) and beyond 40 very seriously obese or morbidly obese (Class III). Obese people do need medical attention while morbidly obese people may even require surgical intervention like gastric banding. According to social scientists monitoring the heavy damage caused by obesity in a country like America, same may work out to $ 344 billion by way of increased medical bills and $ 73 billion through lost productivity!

BMI Prime is another mathematical tool to compare body weights among the population though it is not clear why there should be another such yardstick when BMI monitoring has served the world admirably well for the last 180 years. BMI Prime is the ratio between the actual calculated BMI value and the optimal BMI value of 25 and when it is 1 body weight is considered normal.  Aberrations in BMI values do occur in many cases and there is some ambiguity as to how far they are true reflection of health status at least in some people. For example athletes with high lean body mass invariably show higher BMI figures while they are actually very healthy. Same is true with people with varying body frames but same weight. When it comes to Asians, in stead of BMI of 25 as normal, the recommended optimum BMI value is 23. Fat levels in the  body, especially the visceral fat is not considered in the BMI calculations as it very significantly plays a role in obesity and there fore the protocols like FFMI and FMI are being mentioned as more appropriate to determine the body health of the population. 

As fat levels have great influence in body weight changes, many health experts believe BMI needs to be linked to the body fat content some way to reflect the real health of a person. Total body fat varies any where from 20% to 30% for human beings with women having almost one and a half time that of men. If the body fat content exceeds 32% it is considered as reflecting  real obesity in women while in case of men values above 25 indicate on set of obesity. But measuring body fat is not that easy because of enormous variations encountered with different techniques available to day. Hydrostatic weighing or underwater weighing is often considered as most reliable method of fat assessment in human body though other techniques like skin fold measurement, body girth determination, body impedance, air displacement method, body scanning etc are also deployed for the same purpose by different investigators.   

All said and done, there are still gaps in the science of assessing obesity though BMI, the mainstay of medical research on body size and its relationship to health. But while the BMI is a fine measure of a large population's tendency toward illness and early death, it's a poor predictor of those outcomes in individual patients. According to a new study waist circumference may be a better predictor of health as it is an indication of presence dangerous fat deposits around visceral organs though measurement of this parameter is not easy as discussed above. The new paradigm called A Body Shape Index with the acronym ABSI is calculated as waist circumference in centimeters divided by the product of multiplying the square root of height in centimeters with cube root of BMI. If those who developed ABSI are to be taken seriously, this new technique can predict the chances of those who face higher risk of death within the next five years as per their extensive field studies of thousands of people with varying degree of over weight. It is known that those who are obese are more vulnerable to diseases like Type II diabetes, CVD and some types of cancers but the danger is more from the the unwanted fat deposits which are now factored into ABSI. With over 78 million adults and 12.5 million children reported as obese in the US, this country has a vital stake in developing this tool further to save enormously in terms of saved lives and wasted resources. 

V.H.POTTY
http://vhpotty.blogspot.com/
http://foodtechupdates.blogspot.com

'WEIGHTY' PROBLEM-DIETING VS EXERCISE

Weight watchers are often confused as to the best course available to them to reduce or maintain their Body Mass Index (BMI) as every one knows about the disastrous consequences of BMI beyond 25. Any BMI beyond 30 is a distinct threat and warning for the onset of the much dreaded Obesity development and the consequent increased chance of morbidity. There are two distinct issues in this much discussed area of concern to people all over the world. Whether weight can be controlled by exercise alone or dieting is absolutely necessary or not. What does the science say?

It is simple logic that when input is more than out put the excess needs to be stored and same logic applies for weight gain also. Man needs about 2000 kC of energy for day to day maintenance and incremental growth and depending on the physical work, the energy need will increase proportionately. Olympian Mark Spitz, the unchallenged swimming ace is reported to be consuming a 10000 kC diet but as one can see he is a slim figure as most of the energy is burned during his work out. Nutritionally the food consumed directly goes for performing day to day work and if the stored body fat is to be eliminated to achieve weight reduction one must undertake rigorous physical activity to draw body fat as the energy source.

Imagine the energy expenditure for a 1000 meter walk which is less than 100 kC and if 5 kg body fat needs to be shed, one may have to walk at least 50 km without increasing the energy intake. But walking 50 km with a restricted diet requires determination and perseverance which very few people have. Therefore dieting with reduced calorie intake and moderate exercise only can succeed in weight reduction. The issue gets more complicated when the calorie expenditure in many individuals is much less than the ideal 2000 kC because of their sedentary life styles with minimum physical exertion. The basal metabolism to maintain the vital body functions requires 1200 kC and the actual daily calorie needs in many cases will lie between 1200 and 2000 kC. Therefore even a 2000 kc diet may be converting excess calories into body fat for storage in many people and consequent increased body weight gradually. The mistaken belief that exercise can reduce weight irrespective of what is consumed must be removed from the minds of weight watchers. It has been scientifically established that physical exercise has many benefits like strengthening of bones and muscles, lowering of blood pressure, improvements in mood and mental health, lowering of cholesterol levels, reducing risks associated with CVD, diabetes, breast cancer and colon cancer but expecting to reduce weight might not be realistic from normal exercise regimen.

V.H.POTTY
http://vhpotty.blogspot.com/