to come by a New Year resolution list of 2012 without a tilt towards health,
fitness, dietetic regimen meticulously compiled from magazine snippets or
bookmarking web pages on fruit mélange, vegetable combo, 'poulet' for
consumption' for 'specific purpose' (intriguing!). Point is whatever drove you
to make the list where you allotted a space for your health and wellbeing,
Medindia applauds you and wishes you to stay motivated with expert guidance
from Dr. Dharini Krishnan Ph.D, Registered Dietitian, and Former National
President of Indian Dietetic Association.
Q. What goes into diet counselling?
Diet counselling involves lot of skills, dieting techniques, the nutritional
part of it plus you need to know psychology. Sometimes patients, for example
diabetics, are actually in a state of shock when they walk in. You have to calm
people before you tackle diet counselling. When talking of diet, you have to
make sure that the person is at ease to listen to what you are saying. So diet
counselling involves lot of psychological counselling even if not for any
particular medical attention.
Q. In general what is taken into
consideration to prescribe a diet?
'A' stands for Anthropometric measurements - height, weight, body fat, skin
fold thickness. 'B' for Biochemical measurements, if one has any reports of
their blood profile we look into it and 'C' for Clinical analysis where a
person's eyes, hair are observed. By looking into a person's eyes a trained
health professional will know if one is anemic, by examining the hair it can be
inferred if the person has protein deficiency, nails give away the health of a
person. And then we arrive at 'D' for Diet.
Q. How is a diet prescribed?
Before suggesting a diet, we ask the person about their current diet and then
take detailed dietary calls. We take inputs on what the person eats on a
weekday and what on weekends. We also take inputs on the person's allergy; it's
imperative since food allergies are common today. Family also matters, so we
find out what they do? How much oil they use per month? How much vegetable they
eat per day, per week? How often they eat out? if they do where is it they eat?
Do they eat at restaurants where only fried stuff is available or where salads
are available? We need to know people's lifestyles.
Q. Does physical appeal impact on a diet?
We follow certain parameters and formulas, with their height and weight. Then we decide how overweight or underweight
they are, so formula used is customised for the person. Just because somebody
wants to lose or gain weight we are not going to help. Suppose in a hospital, a
burn patient needs attention, we look into the surface area of the burn, the
area that is burnt, the depth of the burn, according to the need the diet
changes. Even for a normal person, height and weight are normal parameters from
which we need to start off.
Q. Is natural food sufficient or does a
person need supplements?
As long as a person is eating properly, regularly, traditional meals cooked
daily, there is no need for supplements. Supplements have a role only in people
who are not eating properly anddepend on processed foods. For example, if a
person is staying in a PG (Paying Guest) accommodation, if the place does not
allow them to cook, they are dependent on outside food, always. Unfortunately,
in India you get food stuff only of two types that are rich in carbohydrates
and fats. You don't get vegetables and fruits in large quantities for an average
Indian which is hygienic and can be eaten outside. For such a person, if the
hemoglobin is unbalanced then we may have to resort to supplements. In a normal
family, cooking sensibly and regularly it is not needed.
Q. An ideal balance between meat and
vegetable - how does one decide?
Meat is not equated to vegetables at all. If you take any meal, let's leave
breakfast alone because it does not have all the five food groups. However
lunch and dinner are two major meals. The first part is cereal which is rice or
chapatti. The second is dal or meat which is the protein source and the third
being vegetables. The fourth is dairy which is optional, because in a
vegetarian diet, whether it is curd or milk or paneer it adds to the protein
value. It gives you high biological value. Hence meat can be equated only to
dals. Recent trends promote a wrong thought -
where non-vegetarians on a day they take non-vegetarian food do not take
vegetables and this is not the best practice. A decade ago non-vegetarians ate
vegetarian food in a meal with meat. But because of affluence and other
influences people eat only meat which is not a good turn.
Q. Is it safe to quit meat all of a
sudden and become a vegetarian?
Does not matter as long as you take care of the total protein. A non-vegetarian
family does not take as much dal or milk as much as a vegetarian. So if a
person moves from non-vegetarian to vegetarian food they have to take care of
these two things and the person will do fine.
Q. And what if a vegetarian shifts to non-vegetarian diet?
It does not matter as long as vegetable intake continues. So if dal is replaced
by fish or chicken or egg it doesn't matter. But if you leave vegetables and go
headway with meat then the balance will flip.
Q. When is the ideal time to visit a
Back in 1987 when my name board went up people did not understand who I was or
what I did but today women before they get pregnant come asking, What food is
good for healthy pregnancy? What do I eat before the baby is born, What food
should I give the baby until six months? After six months? At every stage
people are concerned about the right diet. Many kids who are taking their Board
exams, starting December till March don't go to school. After giving their
exams, they hang at home, eat and put on weight. The moment 10th
standard and 12th
are over they come to us saying, "Suddenly we have put on so much weight, we
have to go live in the hostels, what diet do we follow?". So, different age
groups come to us. For kids parents accompany them but right from teenagers
onwards people come to us either to put on weight or lose weight. "Is it the right balanced meal that we eat?"
is another common question.
At what intervals do you change a person's diet?
We take a pattern of the family and we give them dietary options. We give them
options of vegetables, fruits and quantity for each person. People who are
losing or gaining weight we see them at an interval of two weeks, at least for
five visits until they fall into the pattern. Those who want to lose 20 kgs or
40 kgs come every 15 days. They want new advice, re-iteration, they want to
check their weight in the same scale. They want to take measurement of their
hands and thighs and waist so the fat is going down and not the lean body mass.
Every 15 days there's a change of diet, if they want a change, then there's
travelling and what diet to follow while travelling. The change in weight and
measurements shows in 15 days, if they follow the advice strictly. Weekend and
week day options are worked out.
Q. How safe is comfort food?
Comfort differs from one person to another. Some say I have to have a chocolate
truffle. I have a 'sweet tooth' is a very common statement. We give them
options of the right sweet. We use sweet for people who need to put on weight.
We use it so that they eat a little more of the right things. If a person looking to put on weight delights
in 'payasam', we allow the sweet dish
if it is made with green gram/Bengal gram , that's high in protein, along with
sugar and milk. We develop comfort food which can be used judiciously. So the
rest of the time they follow the diet we are very happy. We teach them to share
their dessert or sweets. The size of a laddu used to be like a ping pong ball
today it resembles a tennis ball. Somehow in India we take one serving of any
food; size does not seem to worry people.
On a general note Dr. Dharini Krishnan commented on
people making sweeping statements that they don't like vegetables at all, which
is not fashionable at all. Vegetable and fruits are the sustainers. These are
the ones which give you vitamins you don't get enough from cereals or pulses.
Dietary fibres you get more in fruits and vegetables. More intake of vegetables
and fruits the less of diseases. Because the greater the intake of fruits and
vegetables the lesser would be the calorie load on the body. Whether we are
heavy or light or fat or thin it doesn't matter as long as we can avoid illness
from healthy eating. Vegetable and fruits build immunity, and provide
anti-cancer properties. Fibre makes you eat less of high calorie food. When asked how a person remains disciplined,
she said, "If you love yourself, you will take care of yourself".