Food for Thought

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Dr. Dinesh Arab is a cardiologist at AdventHealth Daytona Beach, Department of Medicine Chairman, and Division of Cardiology Director.

The new American Dietary Guidelines released in January recommend a decrease in the added sugar intake to ten percent of daily calories, based on a 2000 calorie daily diet. This works out to 12 teaspoons of sugar a day. The current average American currently consumes 22 teaspoons of sugar a day. This sugar intake does not include naturally occurring sugars present in milk and fruit.

The other two major changes are the removal of cholesterol restrictions, from the previous recommendation of limiting it less than 300mg a day. This is based on the inconclusive evidence between cholesterol-rich foods and LDL (low density cholesterol) or bad cholesterol. The recommendation for limiting intake of saturated fat to 10 percent of daily intake stands.  Examples of saturated fats are whole milk, butter, coconut oils and meats not labeled lean. The sodium levels should be restricted to 2300 mg a day. There are a number of online and mobile applications that can help you maintain your daily diet.

The obesity epidemic in America started in the late 70s. Prior to that, obesity levels were less than 45 percent, as opposed to current levels of two-thirds of the American population. When I first read about the obesity problem in America in the 80s, I couldn't believe a place like that actually existed. The land of plenty, appeared to be a paradise on earth. The biggest problem for me growing up, was constant hunger. Even today, 195 million people in India go hungry every day.

I was sent to a boarding school at the age of six along with my older brother. We lived on a tobacco farm in rural India, without any decent schools in the area. The food in the first school was something out of a Charles Dickens novel. Second helpings did not exist. I remember at the end of the first day, we were all taken to the dining room, and as the names of the children were called, each of them were given a packet of candy and snacks. I kept waiting for my name, but it never came. When the teacher was shutting the box, I put my hand up and pointed out that I did not receive a packet. She told me that this was the extra food sent by parents for their children. My parents were unaware of this provision.

When my mother came to visit us after the first month, I remember laying into her. In the middle of my tirade about being hungry, cold, and miserable, my brother nudged me, and I stopped when I saw the shocked expression on her face. It was the hurt expression of a mother of a hungry child, one that I will never forget. I got to see that same helpless expression - constantly -during Medical school. Unknown to me, she had traveled alone by bus for over 10 hours in unsavory conditions, and was staying in a run-down place on a very limited budget. The next time I went to school, I had an extra trunk of food.

Both of us were severely undernourished and infested with parasites, despite my mother giving us anti helminthic treatments every year. Like most mothers in India, she acted as our doctor. She was a pragmatic lady. She started feeding us meat, despite it being against our religious doctrine. When I went to Medical School, I continued to have nutritional issues. I remember one day biting into an apple and one of my teeth breaking off due to calcium deficiency. We would visit villages, to educate the population about balanced diets, and nutrition. The scenes in some of these places were akin to the concentration camps I had watched in movies. Most of the pediatric admissions were because of starvation.  Marasmus and Kwashiorkor, both syndromes of acute malnutrition, were common diagnoses. I looked well-fed by comparison.

In an unseeing paradox, 795 million people in the world deal with hunger on a daily basis, while we in America fight obesity. Diet is a major contributing factor for most of the chronic conditions in America including diabetes, heart disease and cancer. Ironically diet is also responsible for most of the chronic conditions in the developing world including TB, rheumatic fever and gastrointestinal infections.

I now deal with first world problems and force myself to eat oatmeal for breakfast, and walk past piles of cookies at work during the holidays, shaking my head at the problem of plenty. I am sure some kid on a tobacco farm in rural India, would love to have the problems that we find so weighty.

Dr. Dinesh Arab is a cardiologist at AdventHealth Daytona Beach, Department of Medicine Chairman, and Division of Cardiology Director.

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