Latest news with #AsianIndians
Hans India
03-07-2025
- Health
- Hans India
Holistic approach to type-2 diabetes management and the role of lifestyle factors
As a country, we are dining out and ordering in like never before. Convenience aside, the salty snacks and sugary desserts that get delivered to our doorstep in less than 30 minutes, come with consequences. Sheela Krishnaswamy, Wellness & Nutrition Consultant shares that an exhaustive, decade-long study published in Lancet in 2023, found that 101 million people in India are living with diabetes and another 136 million people could be living with pre-diabetes. Some people in India are genetically predisposed to developing type 2 diabetes, which is exacerbated by lifestyle factors including lack of exercise and eating an unhealthy diet. Healthy dietary habits, maintaining a healthy weight, and getting adequate exercise, are some of the factors that can help to prevent type 2 diabetes. In most people with Type 2 diabetes, the pancreas does not produce enough insulin (a hormone critical for transporting blood sugar into cells) and cells respond poorly to insulin and take in less sugar (insulin resistance). Eating a healthy diet is an important strategy to prevent and manage type 2 diabetes. Even small changes in dietary habits can lead to significant, long-term health benefits. In India, eating almonds every day has been a time-honoured tradition. The wisdom of this practice is supported by a wealth of recent scientific studies. The latest Dietary Guidelines released by the ICMR-NIN, recommended the regular consumption of nuts like almonds as part of a balanced diet. Almonds are recognized not only as an excellent source of natural plant-based protein but also as a nutritious, healthy snack that contributes to overall well-being. Two studie s by the National Diabetes, Obesity, and Cholesterol Foundation (NDOC), designed to ascertain the impact of simple changes to an individual's diet, found that consumption of 20 grams of almonds before each major meal benefited blood sugar control both in the short-term (over three days) and in the long term (over three months) among Asian Indians with overweight/obesity and prediabetes. The three-month intervention reversed prediabetes in nearly one-quarter of the participants. The study results must be viewed in the context of the overwhelming array of associated risks and complications—heart attack, stroke, kidney damage, limb amputation, blindness, and nerve damage—that diabetes brings with it. More than 60% of people with pre-diabetes are likely to convert to diabetes in a span of five years. Moreover, 50% of people are unaware of their diabetic status, further increasing chances of these complications. There's yet another pertinent reason for caution. Asian Indians—characterized by tendency for abdominal adiposity, higher waist circumference, lower BMI, and greater insulin resistance—are more prone to developing diabetes. It is also well documented that obesity increases diabetes risk. A seminal study conducted on overweight and obese Asian Indian adults found that eating 43 grams of almonds daily for 12 weeks reduced insulin resistance, improved insulin sensitivity, and helped control blood glucose levels. The people eating almonds achieved significant reductions in body weight, body mass index (BMI), and waist circumference over the intervention period and lowered their total cholesterol. Overtime, these changes could reduce the risk of diabetes and other cardiometabolic diseases. Rich in natural sources of some of the essential nutrients, almonds are a smart and satisfying food not only for blood glucose control but also to boost intake of key nutrients. A typical 28 grams serving has 13 grams of unsaturated fat and just 1 gram of saturated fat. They make for a good snacking choice as they are also a rich and natural source of plant protein, dietary fiber, monounsaturated (good) fat, Vitamin E, magnesium, and phosphorus. Their daily consumption is known to decrease the intake of carbohydrate calories and even help in lowering the blood sugar impact of carbohydrate foods, which affects fasting insulin levels.
New Indian Express
27-04-2025
- Health
- New Indian Express
New guidelines target dual epidemic of diabetes, liver disease in Indians
NEW DELHI: With Asian Indians facing a rising 'dual epidemic' of Type 2 Diabetes (T2D) and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), top Indian medical experts have released new consensus guidelines tailored specifically for this high-risk population. Published in the journal Diabetes and Metabolic Syndrome: Clinical Research and Reviews by Elsevier, the guidelines offer evidence-based recommendations for the diagnosis and management of MASLD in Asian Indians with coexisting T2D—two conditions that significantly aggravate each other. 'These guidelines are necessary because Asian Indians show unique metabolic characteristics with higher liver fat deposition than other ethnic groups. India faces a 'dual epidemic' of T2D and MASLD, with each condition worsening the other,' said Dr Anoop Misra, Chairman of Fortis CDOC Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, and lead author of the guidelines. MASLD, previously known as non-alcoholic fatty liver disease (NAFLD), has become the most common cause of chronic liver disease globally. In India, its prevalence ranges from 27.7% to 88.6% across different population subgroups. Among high-risk Asian Indians—those with obesity, diabetes and other metabolic conditions—the prevalence reaches 52.8%, compared to 28.1% in average-risk individuals, according to a systematic review and meta-analysis cited in the document. 'While guidelines exist for MASLD globally, none specifically address management in individuals with T2D,' said Dr Misra, recipient of India's highest medical honour, the Dr B.C. Roy Award in 2006, and the Padma Shri in 2007. MASLD is not only the leading cause of liver-related morbidity and mortality but also an independent risk factor for cardiovascular disease—the primary cause of death in this demographic. The new guidelines, developed in collaboration with senior doctors from institutions such as AIIMS, Sir Ganga Ram Hospital and Medanta, recommend routine MASLD screening for all T2D patients, especially those with high-risk features like metabolic syndrome and obesity. 'Clinical evaluation should include BMI, waist circumference and waist-to-height ratio, with non-invasive tests like FIB-4 and liver stiffness measurement to assess fibrosis,' said Dr Misra, who also heads the National Diabetes Obesity and Cholesterol Foundation (N-DOC). Weight loss is identified as a critical intervention, improving outcomes for both MASLD and liver fibrosis. The guidelines recommend lifestyle modifications, including a diet comprising 50–60% complex carbohydrates, 20–30% fats (primarily unsaturated), and 15–20% proteins. They advise limiting saturated/trans fats, refined carbohydrates and added sugars. A plant-based diet is encouraged, incorporating legumes, nuts and seeds, which are rich in dietary fibre and essential nutrients that support liver health and reduce inflammation. For non-vegetarians, the guidelines recommend fish and seafood—particularly fatty varieties like salmon and mackerel—due to their omega-3 polyunsaturated fatty acids (PUFAs). In contrast, red and processed meats should be minimised or avoided due to their link to MASLD progression. Other key recommendations include engaging in 150–300 minutes of moderate or 75–150 minutes of vigorous physical activity per week, and complete avoidance of alcohol. The experts—Dr Ashish Kumar (Professor and Senior Consultant, Gastroenterology and Hepatology, Sir Ganga Ram Hospital), Dr Mohammad Shafi Kuchay (Senior Consultant, Endocrinology and Diabetes, Medanta), Dr Narendra Singh Choudhary (Associate Director, Hepatology, Medanta), and Dr Naval K. Vikram (Professor, Internal Medicine, AIIMS Delhi)—also pointed to the harmful impact of certain fats prevalent in Indian cooking. They warned that high consumption of saturated fatty acids (SFA) and trans fatty acids (TFA), especially from ultra-processed foods and repeatedly heated edible oils, contributes to hepatic fat accumulation, insulin resistance and inflammation. 'It is crucial to limit oils high in saturated fats (ghee, coconut oil, palm oil, butter, cream, animal fat) and omega-6 PUFAs, as excessive intake has been linked to inflammation and liver fat accumulation,' the experts said. Regular coffee consumption—more than three cups per day, particularly caffeinated and brewed varieties—was associated with improved liver enzymes, reduced liver fat and decreased inflammation. 'The guidelines provide clinicians with a practical framework for managing MASLD in people with T2D, accounting for the unique metabolic characteristics of Asian Indians. It offers specific, evidence-based recommendations for screening, assessment frequency, and interventions, with clear algorithms facilitating clinical decision-making,' said Dr Misra. He added that the guidelines also outline when to refer patients to specialists and offer a comprehensive roadmap to target both glycaemic control and liver health.
