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Magazine
Dietary dilemmas
DR. GEORGE THOMAS
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The variety of freely available dietary information that confuses patients is one doctor’s bane.
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Part of my job as a cardiologist is to give dietary advice to my patients. Most people attribute their heart problems to diet. In one way they are right. A wrong diet when combined with the wrong genes and a wrong lifestyle could indeed be bad. But m
y problem is the variety of freely available dietary information that confuses my patients.
When I told Mr. Rao that three eggs a week is fine, he shows me an article stating that eggs are bad. On another occasion I had told Mr. Menon that coconut oil contains saturated fat. But he brought a whole lot of literature on the benefits of coconut oil.
The other problem is an obsession with cholesterol figures. Shobha is diet faddist. She checks her cholesterol every three months and keeps a record. A few digits lower would cheer her up while a few digits higher would make her depressed. Once when her bad cholesterol level went up, she was on the verge of tears. I told her to cheer up and asked, “What’s your good cholesterol?” That had gone up too. I told her that those numbers would counter the effects of the bad one.
Polemical spats
My interaction with patients of different religious dietary practices could have led to polemical spats. But I follow the message displayed in many Kerala hotels “Do not discuss religion or politics here.” In my clinic I add ‘religious diet’ to the list.
Mr. Subramaniam feels milk is for calves, not for human consumption. By the same logic, aren’t fruit meant for the propagation of the species. Then, should we be eating them? Leaves produce nutrients for the plant. Should we be eating them? Similarly, the extraction of honey is a virtual bloodbath and daylight robbery.
The dividing line between vegetarianism and non-vegetarianism is too blurred. We have a pitcher plant that eats insects! We should not be making a hue and cry on the food we eat. Leave it to each one’s taste and choice.
Amid all this confusion I decided do some research on diet. I googled “diet” and got 149,000,000 results in 0.05 seconds. That I am sure would add to the confusion for a patient in search of the dietary nirvana.
So I sought the scriptures. Probably I could find the holy grail of dietary advice in them. A simple mantra for good health would be to eat well but work well too and do not forget to get good rest and sleep.
Ancient wisdom
What are the other lessons we could draw from ‘ancient’ wisdom? I tried to trace the history of dietary advice. We have many human behaviour specialists. We have experts advising on how to bring up children, how to breathe, how to make love and so on.
But the professional dietician is a recent phenomenon. The cup and spoon, gram and ounce quantification of the food we eat is a modern idea. Similarly classification of foodstuff into carbohydrates, proteins, fats and vitamins came very late in the history of mankind. In the past man ate what he liked. The body has innate signals of craving so that we eat the foodstuff that is required most.
Going back in time was an eye-opener. The early man did not process the food. No elaborate cooking. No mass production. No refining. So the key would be to eat natural food as far as possible. Eat whole grapes rather than drink its juice. Similarly popping ‘antioxidant’ vitamins pills may not be a good idea. Fresh fruit and vegetables would be the answer.
Going back in time I also tried to figure how cigarettes, the bete noire of cardiology, came into existence. The Britannica entry on ‘cigarette’ tells us “the Aztecs smoked a hollow reed or cane tube stuffed with tobacco. Other natives of Mexico, Central America, and parts of South America crushed tobacco leaves and rolled the shreds in corn (maize) husk or other vegetable wrappers”. I cannot but agree with the Shavian definition of a cigarette as something with fire at one end and a fool at the other.
Moderation is key
The dietary practices are as diverse as mankind itself. No food is to be condemned. But, as our seers have said, even amrut or heavenly nectar in excess could be poison. So moderation in everything should be the motto. Similarly, variety is the spice of diet!
Recent research published in the Journal of the American Medical Association suggests that concept of low fat diet to prevent heart disease is a big fat lie! Their conclusion is that excess of anything is bad. So I don’t make a fetish of diets. Cholesterol is in the genes. If someone’s cholesterol is high I just put him on Storvas.
The author is a cardiologist based in Kochi. E-mail: gthomas@doctor.com
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