ICMR releases Dietary Guidelines for Indians after 13 years, says no to protein supplements

The National Institute of Nutrition (NIN) under the apex health research body said that healthy diets and physical activity can reduce a substantial proportion of coronary heart disease (CHD) and hypertension (HTN) and prevent up to 80 percent of type 2 diabetes.

“A significant proportion of premature deaths can be averted by following a healthy lifestyle,” it said in a statement.

The upsurge in the consumption of highly processed foods laden with sugars and fats, coupled with reduced physical activity and limited access to diverse foods, exacerbate micronutrient deficiencies and overweight issues, it added.

The Dietary Guidelines for Indians released yesterday at @ICMRDELHI can now be access at : https://t.co/pTslkYlY73https://t.co/PC9HwI8Unm@MoHFW_INDIA @DeptHealthRes @ICMRDELHI pic.twitter.com/l9wgur9k7a

— ICMR – National Institute of Nutrition (@ICMRNIN) May 9, 2024

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‘DGI relevant to changing food scenario in India’

The Dietary Guidelines for Indians (DGIs) has been drafted by a multi-disciplinary committee of experts led by Dr Hemalatha R, Director, ICMR-NIN and has undergone several scientific reviews.

“Through the DGIs, we emphasise that the most logical, sustainable, and long-term solution to all forms of malnutrition is ensuring the availability, accessibility and affordability of nutrient-rich foods while promoting consumption of diverse foods,”Hemlatha said.

“The guidelines contain in them scientific evidence-based information that would facilitate the attainment of goals stated in the National Nutrition Policy,” she said.

The dietary habits of Indians have undergone significant changes over the past few decades, leading to an increase in the prevalence of NCDs while some of the problems of undernutrition continue to persist, said Dr Rajiv Bahl, Director General, ICMR.

“I am pleased that these guidelines have been made very relevant to the changing food scenario in India with addition of practicable messages and suggestions on handling food safety, choosing minimally processed foods, importance of food labels and physical activity,” he said.

“I am sure these will complement the government’s efforts to promote holistic nutrition and health of our people,” Bahl said.

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The guidelines

The NIN recommended restricting salt intake, using oils and fat in moderation, doing proper exercise, minimising sugar and ultra-processed foods.
It also suggested adopting a healthy lifestyle to prevent obesity and reading information on food labels to make informed and healthy food choices.

Referring to the non-communicable diseases, the NIN said that 34 percent of children between 5-9 years of age suffer from high triglycerides.

A balanced diet should provide not more than 45 percent calories from cereals, and millets and up to 15 percent of calories from pulses, beans and meat.

Rest of the calories should come from nuts, vegetables, fruits and milk, the guidelines said.

Due to the limited availability and high cost of pulses and meat, a significant proportion of the Indian population relies heavily on cereals, resulting in poor intake of essential macronutrients (essential amino acids and essential fatty acids) and micronutrients, the NIN said.

Low intake of essential nutrients can disrupt metabolism and increase the risk of insulin resistance and associated disorders from a young age, it said.

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‘Avoid protein supplements’

The NIN had called for avoiding protein supplements for building body mass.

In the DGIs, the NIN stated that prolonged intake of large amounts of protein powders or consumption of high protein concentrate has been associated with potential dangers such as bone mineral loss and kidney damage.

“Many athletes consume very high amounts of protein, often as protein powder. Protein requirements are not so high as commonly perceived. In fact, research finds that that dietary protein supplementation is associated with only a small increase in muscle strength and size during prolonged resistance exercise training (RET) in healthy adults,” it said.

Protein intake levels greater than~ 1.6g/kg/day do not contribute any further RET-induced gains in muscle mass,” said the guidelines.

It also stated that sugar should be less than 5 percent of total energy intake and a balanced diet should provide not more than 45 percent calories from cereals, and millets and up to 15 percent of calories from pulses, beans and meat.

The rest of the calories should come from nuts, vegetables, fruits and milk. Total fat intake should be less than or equal to 30 per cent energy, the guidelines said.

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The pros

Kerala-based hepatologist Dr Criac Abby Philips said that the positive aspect of dietary guidelines lies in its inclusive approach towards diet, favoring a plant-based diet while also advocating for the rational inclusion of animal-based protein, including lean red meat.

It recommended consuming approximately 70g of animal protein per day or around 500g per week, divided into two portions.

Furthermore, the guidelines emphasised the importance of including milk in daily diets for individuals across all age groups, from children to adults, including special adult groups.

“Additionally, the guidelines discourage the use of non-evidence-based Ayurvedic diets or traditional supplements for normal adults or special groups such as pregnant and lactating women. Specifically, it advises against special Ayurvedic supplements like Lactare and fenugreek for lactating women,” he wrote on X.

The recommendations discouraged the use of branded weaning or complementary foods, such as Cerelac and Nan-Pro, and recommended recipes for infants after 6 months of age that exclude eggs, fish, and honey.

However, seed oils are deemed acceptable for daily consumption.

Moreover, the guidelines suggested limiting saturated fats, such as ghee, palm oil, and coconut oil, in the diet, contrary to traditional beliefs that consider ghee and coconut oil as “healthy fats”.

There are no specific recommendations regarding drinking positions, indicating that both sitting and standing positions are acceptable for consuming water.

Furthermore, the guidelines offer steps to address deficiencies in a vegetarian-only diet and ways to enhance protein intake in a vegan diet.

They advised limiting processed foods while suggesting healthier alternatives whenever possible.

Additionally, the guidelines clarified that while yoga is considered a form of physical activity, it is not categorized as physical exercise or aerobic exercise, which is an accurate distinction.

Lastly, it also dispelled myths surrounding the superiority of pink salt and black salt, as well as the notion of any “healthy” sugar. Refined sugar, jaggery, and honey are all sugars, with none being superior to the others, it said.

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The cons

Drinking eight glasses of water a day for normal adults is not based on scientific evidence and is wrong.

Inserting Yoga into physical activity guidelines as if it is something significant is unwarranted. It is not.

Demonising protein supplements and wrongly associating branched-chain amino acids to the risk of non-communicable diseases is misleading. Infact, they are beneficial for metabolic health.

Avoiding “excessive” coffee (without defining it) and preferring tea based on misconceptions that coffee increases blood pressure, heart rate abnormalities and bad cholesterol leading to heart disease is all wrong.

“No mention of avoiding alcohol, instead only describing how bad alcohol is. Long term use of non-calorie sugar substitutes and risk of overweight/obesity, diabetes and hypertension is not well referenced. This is a myth. Read FSSAI labels for proper guidance. I do not think so,” said Dr Philips.

The Indian Council for Medical Research – National Institute of Nutrition dietary guidelines for Indians 2024 just dropped. This is a revised edition from 2011.

Lots of good things, but unfortunately a lot of nutritional myths have found place in this national guideline. Whoever… pic.twitter.com/xtWDkxznaB

— TheLiverDoc (@theliverdr) May 8, 2024

“What the guidelines really meant is to avoid protein supplements approved by FSSAI. It is safe to take protein supplements approved by other serious regulatory bodies and valid independent third-party certification,” said Dr. Abby.

He added, “I would really love to see an athlete or bodybuilding professional requiring 1.5 to 2g/kg of protein a day take all of it through ‘balanced natural sources’ without supplementation. It is impossible. Whey protein is natural. It is made from cow milk. People do not even know such basics.”

(Edited by Shauqueen Mizaj)