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Food systems have the potential to nurture human health and support environmental sustainability, however the way the world produces and consumes food is currently threatening both. Evidence Based Nutrition (EBN), primarily focusing on plant-based diets, has been widely associated with a lower risk of premature mortality and protection against Non-Communicable Diseases (NCDs). In addition, plant-based dietary patterns are a powerful tool to combat climate change.
India is experiencing a “rapid epidemiological transition” that is leading to a significant increase in obesity and other NCDs. This situation underscores the urgent need for a healthcare revolution that supports the transformation of the food system, which is essential for humanity’s well-being and prosperity.
Individual and Public Health: In India, the proportion of deaths due to NCDs was 63% in 2016, with recent surveys showing an increasing trend. It’s estimated that obesity will triple from 2010 to 2040. Unlike the west, more than two-thirds of individuals in the country suffering from NCDs are in the most productive-life age group, resulting in a significant socio-economic burden. Unhealthy diets and the resulting malnutrition are major drivers of noncommunicable diseases (NCDs).
Climate Change and Planetary Health: The current food system accounts for around 25% to 30% of global emissions come from our food systems. India had the highest cattle population & livestock were found to be the main sources of greenhouse gas (GHG) emissions in Indian agriculture. A shift towards dietary patterns with lower consumption of animal source foods & increasing the productivity of the agricultural sector remains the best mitigation option for reducing the emission of GHGs from agriculture.
Current Food System In India: The rapid pace of globalization and urbanization has led to shifts in the socio-cultural environment, fostering a dietary culture rich in calories but poor in nutrients. This shift is a key factor in the increasing rates of obesity and metabolic diseases in India. The new dietary pattern is high refined carbohydrate, oils, fried items, sweets, sugars, western fast foods & packaged snacks and beverages. It’s also observed that the dairy consumption in India has grown 4 fold over the last 30 years. In addition there is a growing demand for meat.
India is seeing a “nutrition transition” among vegetarians in India with a decline in the consumption of whole plant foods and increase in processed foods [2]. As per the Eat Lancet Commission report, Indian Diets are low in fruits, vegetables, and whole grains but high in salt, sugar, and fat which are also responsible for India’s increasing disease burden with dietary risks responsible for 22% of all deaths and of all Disability-Adjusted Life Years amongst adults [3]
Current Status of Nutrition integration in Healthcare in India: There are quite a number of nutrition initiatives in India, but most of the existing ones primarily focus on under-nutrition (iron deficiency etc.) in specific target groups, while neglecting over-nutrition related issues (obesity, NCDs etc).
Currently the Indian public relies heavily on the internet, celebrity endorsements and influencers for their nutrition guidance. In the current era of information overload, there is a concomitant increase in misinformation relating to nutrition and we are often exposed to various nutrition & health claims that might not be true and the best way to differentiate facts from myths is to look for evidence-based nutrition.[5]
A KABP study funded by PAN-India revealed that though there is a general understanding of the important role of diet in prevention and cure of disease, there is a reluctance to incorporate this in any serious manner into clinical practices. The study reveals that doctors are inadequately trained in nutrition. Dietary recommendations are traditionally handled by Nutritionists and the compliance level among most populations is very poor.
The Eat Lancet report highlights that a significant reason for the poor quality of diets in India is the lack of awareness and acceptability. Addressing this issue requires a strategy that involves the entire population, spans multiple sectors, draws on various disciplines, and respects cultural contexts. Integrating whole food, plant-based nutrition into healthcare, educating healthcare professionals, and increasing public awareness about the benefits of healthy environments and sustainable choices are key steps toward promoting a healthier lifestyle.[4]
Solution Mindset
The challenges highlighted underscore the necessity for a transformation in the current healthcare system towards a “Nutrition/Lifestyle first Approach.” Doctors, who hold a pivotal position in the healthcare hierarchy and possess significant societal trust, play a vital role in driving this change at individual, public, and national levels, aiming for a “Great Food Transformation.” The most effective strategy to achieve this involves integrating nutrition education into the medical curriculum and prioritizing nutrition interventions in clinical practice as a primary management approach. By equipping doctors with accurate clinical guidelines, resources, and skills, they can effectively implement nutrition interventions. This, in turn, encourages the widespread adoption of diets rich in nutrient-dense, whole, plant-based foods, which can significantly reduce NCDs and GHG emissions, thereby promoting the health of both humans and the planet.
The “Physicians Association for Nutrition India” (PAN India) was established in 2022 as part of the PAN International network. We align with the global strategy of PAN International on our mission to integrate nutrition-specific interventions into health systems in India by empowering health care professionals with the tools, techniques and know-how to treat their patients with the power of evidence-based nutrition (www.pan-india.in).
Learning & Engagement Activities at PAN India
PAN India has developed a variety of learning and engagement initiatives for doctors across the country. We’ve successfully organized eight in-person Continuing Medical Education (CME) events at several medical colleges and healthcare institutions, including notable ones at AIIMS Jodhpur, Nagpur, and Bilaspur. These events featured case study presentations by experts, panel discussions, EBN quizzes, elocution, and research study presentations by medical students, along with healthy whole food plant-based (WFPB) meals.
Our EBN CME programs for practicing doctors have been particularly successful, attracting around 150 doctors at each event in major cities. To date, we’ve held four such events, covering all medical specialties. We’ve established associations in each medical college and city, and selected and trained ambassadors to ensure the project’s long-term sustainability. WhatsApp groups have been created to facilitate easy communication within the domain.
So far, we’ve built a network of approximately 2000 practicing doctors and 2000 medical students. This network’s ongoing learning and engagement are supported through our online training platforms. PAN has formed three teams that conduct three online educational training programs for doctors, including 22 online sessions on EBN webinars, journal clubs, and discussion forums.
Our dedicated medical content team has published a book to help doctors in our network transition to healthier eating patterns that benefit both individual and planetary health. We’ve distributed 500 copies to date and are preparing to release an improved version with recipes for local dishes from each state.
Additionally, we’ve coordinated the “Green Food Experience,” an initiative by PAN International, to encourage university students to offer healthy plant-based food options on their campuses. This initiative aims to promote plant-based eating, build community, and support planetary health.
PAN India’s team includes physicians and specialists in medicine and nutrition, all dedicated to supporting the organization. Through collective wisdom and a commitment to public health outcomes, PAN India continues to inspire and empower healthcare professionals to adopt evidence-based nutrition practices, shaping a healthier future for everyone.
Authors:
Dr. Sindhura,V.V.N- PAN India
Dr. Pritham, S.M- PAN India
Dr. Rajeena Shahin- Medical Director PAN India
