The big meal deal

At 67, T.P.C. Mani feels fit as a fiddle. For the past 15 months, he has been fasting 17 to 18 hours every day. He eats only two meals a day, ensuring there is a gap of six to seven hours between both the meals. Through the day, he sips water and buttermilk alternately to avoid feeling hungry. He weighed 78kg before he started the diet, and within two months, he shed five kilos. He now weighs a healthy 70kg, which has so far remained constant. "I tried a number of other diets before this one, but nothing seemed to really work," said the Mumbai sexagenarian who used to work for an MNC. He begins his day with a wholesome breakfast and has lunch at 2pm. His next solid meal is the next day's breakfast. "My body has gotten so used to it that I do not feel hungry in-between. The liquids fill me up. The best part about this diet is that it does not restrict me in any way. I can eat anything I want as far as I am eating only twice a day, and that too when I feel very hungry," said Mani.

Mani reveals that he follows what is popularly known as the Dixit diet. It was somewhere in the first quarter of 2019 that the two-meals-a-day diet plan—named after Dr Jagannath Dixit, a then low-profile medical college professor from Latur, Maharashtra—gained popularity as a magic formula for weight loss, especially for the obese and diabetic. Soon enough, millions tuned in to Dr Dixit's YouTube lectures. By November, he was appointed as the brand ambassador of Maharashtra's anti-obesity and anti-diabetes campaign, much to the chagrin of the state's Indian Medical Association, which demanded a scientific validation to his diet plan that advocates just two meals a day. The doctor, who is now associate professor at the Government Medical College, Aurangabad, recently presented his book to Prime Minister Narendra Modi, claims that if one diligently follows the diet, not only will it lead to an average weight loss of 6.8kg in six months, but it will also steady sugar levels and might even result in a “reversal of diabetes”. “The logic is simple,” said Dr Dixit. "We have essentially been a civilisation that has been used to eating twice [a day]. Our cells and bodies are designed for starvation and not for over-eating. The food we eat is broken down by enzymes in our gut and eventually end up as molecules in our bloodstream. Carbohydrates are quickly broken down into sugar which our cells use for energy, or if not used, it is stored as fats. But sugar can only enter our cells with insulin, a hormone made in the pancreas. Insulin brings sugar into the fat cells and keeps it there. Between meals, as long as we do not snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down because raised levels of insulin are by and large the culprit for weight gain and type 2 diabetes. So the logic is to reduce the secretion of insulin by reducing the number of times one eats. You can eat twice when you are really hungry. The time gap is of no consequence."

Many of his followers, he admits, have confused his diet with that of intermittent fasting (IF). The Journal of Clinical Medicine, which conducted studies to analyse the efficacy of IF as a foolproof weight-loss method, observed: "In healthy, normal weight, overweight or obese adults, there is little evidence that IF regimens are harmful physically or mentally. Almost any IF regimen can result in some weight loss. Among the intervention trials included in this review, 84.6 per cent reported statistically significant weight loss."

While Dixit emphasises limiting the number of meals to two, intermittent fasting involves eating only during a certain window of the day (eight hours) without restrictions, and fasting the rest of the time (16 hours). In essence, in both diets, the idea is to allow the insulin levels to go down far enough and or for long enough that we burn off fat. In IF, one can either eat during a certain window every day or on certain days of the week or eat normally for five days a week and control calorie intake on the remaining two days.

Neha Bhise, mother of a two-year-old, enrolled with a nutritionist for a three-month programme in April last year and lost 10kg by simply following a healthy diet which was not very different from her regular diet. "I simply had to tweak it for faster metabolism and digestion, such as having buttermilk after lunch, methi water on an empty stomach early morning, followed by apple-beetroot juice, brown rice replacing white rice and bingeing on soups and salads for fiber." On a regular diet, she managed to shed 8kg. But once her weighing scale read 55kg, she found it difficult to lose any more weight. It was then that she opted for IF to "shake up the body from its slumber". "By 7pm, I would finish dinner and then fast for 15 hours until 10am the next day," she said.

In contrast, Hemapallavi from Bengaluru tried the twice-a-week IF plan. In addition to the daily 12 to 14 hour fasting, Mondays are water infusions day, Tuesday is only for soups and from Wednesday to Sunday, she would follow a regular diet. From 68kg, she came down to 51kg in eight months. "I was diagnosed with PCOS [polycystic ovary syndrome] before marriage, which meant that my body had the tendency to gain weight," said Hemapallavi. "It really did not bother me much until it really began showing on my body. I was feeling uneasy as I looked much older than my age."

Experts say IF is not new for Indians. "Our parents and ancestors fasted intermittently since ages and we used to mock them. Now, when the west gives it a fancy name, we all want it," said Dr Priyanka Rohatgi, chief nutritionist and dietician at Apollo Bengaluru. "We had very good eating habits in India and a good practice of detoxifying our system ourselves. But with the westernisation of our menus we eliminated a lot of good things and picked up things that worsened our food habits and made us the capital of non-communicable diseases," she said.

Besides IF, which allows one to eat all kinds of food within reasonable limits, the other diets that have been popular and trendy with Indians in the past two years have been the keto diet, the vegan diet, the flexitarian diet, the low-carb high-fat diet and, to a small extent, the paleo diet—all of which require you to either cut out certain things entirely (fats, carbs, sugar) or eat an excess of something else (proteins).

Of late, the vegan diet, which is strictly plant-based, has found a number of takers, especially after Game Changers, a documentary about plant-based eating that was presented by Hollywood director James Cameron, aired late last year. "We had a number of athletes calling in and wanting to go vegan after watching the film," said Ryan Fernando, cofounder and CEO, Qua Nutrition. "But the vegan diet does not work for all. Out of 10 athletes, effective results were seen in only 3 to 4." Instead, he is a firm believer of what he calls the nutrigenomic diet that is based on your genes. "I worked with Sushil Kumar (wrestler) and prescribed him a gene-based diet that [helped] him to win two Olympic medals," said Fernando. Nutrigenomics is the influence of nutrition on genes. It helps to understand the nutritional requirements of the individual and how they react to some nutrients. As per this diet, since each individual is different, with unique genetic variants, one diet does not work for all. "Compare your body to a computer," said Fernando. "Your body is the hardware and your genes are the software. So, when the software malfunctions, the hardware crashes. For example, when genes for gluten are mutated, this leads to gluten intolerance when the body is subjected to wheat, barley and rye." He suggests testing of one's genes before starting any diet.

On two extremes lie diets which became very popular early on—the low-carb high-fat keto diet and the paleo diet. While some have benefited from these, others dismiss them as fads. THE WEEK spoke to Marika Johansson, who is an International Federation of Bodybuilding and Fitness pro athlete and fitness trainer and nutritionist for Bollywood stars like Ranbir Kapoor, Siddharth Malhotra, Alia Bhatt and Katrina Kaif. Johansson said she believes in the keto diet and often advises her clients to opt for it. "Having worked in India for six years, I have realised that keto is one of the most popular diets with Indians," she said. "It works well when you are an endomorph (someone with a high proportion of fat tissue) and need to shed that stubborn fat, provided you also do some form of physical activity. I do not recommend the keto diet for more than eight weeks as carbs are an essential macro for our well-being." About two years ago, when a pasta-loving Ranbir Kapoor felt the need to eat healthy when travelling, Johansson had him covered. She prepared special protein-loaded muffins and "nutritional meatballs" for him with oats, brown rice and minced chicken, flavoured with Tex-Mex and Indian seasoning. A couple of these were enough to fill him up, she said.

For 41-year-old Dhiraj Khurana from Delhi, it became "extremely essential" to lose the protruding bulge on his waist. His aim was to go from 90kg to 75kg by way of a "crash diet" and then work towards maintaining it. Accordingly, he started on the keto and shed 11kg in eight months. But then, anxiety issues and body weakness set in. "I realised that I had to get back to my normal way of eating and simply engage in a physical activity to maintain a good body weight," he said. Ditching cheese pizza and fried pakodas was OK, but going without wheat roti and paratha, which formed the core of his food intake since childhood, was a struggle.

Fernando believes that the keto diet is detrimental to the Indian gene in the long run. "If you are attempting a keto diet, do it under the supervision of a dietician and for no more than six months," he said. His voice finds an echo in Dr Phulrenu Chavan, endocrinologist at Hinduja hospital. "The genetic makeup of Indians is such that we are able to digest 40 to 50 per cent of carbohydrates, 10 to 20 per cent of fats and the rest are proteins. And, our system needs food every three to four hours. You will not be able to maintain a keto diet or any other fad diet for a long period. Even a standalone high-protein diet is not recommended especially for diabetics because proteins are harmful for the kidneys. It worsens it," said Chavan. Clinically, doctors do not prescribe any of these diets. The Indian diet, they say, whether vegetarian or non-vegetarian, has sufficient quantities of carbs, proteins and fats.

Nutritionists stand divided on the efficacy of diets. Even among qualified nutritionists there is no consensus on which diet best suits the Indian milieu. While earlier the focus was entirely on weight loss, and carbohydrates were perceived to be the enemy, no-carb or extreme low-carb diets such as the keto, paleo and Mediterranean diets were in vogue. They ensured quick weight loss and happiness. But then as research evolved, it became clear that carbs are not necessarily bad for the body and doing away with them altogether could be detrimental in the long term. "Most people completely cut out carbs from their diet or eat too little carbs," said Johansson. "But, eating the right amount and from the right sources like rice, quinoa, millet, buckwheat, potatoes and oats will not make you fat. Refined carbs loaded with sugar or fried [food] are the ones making you fat." Accordingly, very-low-carb diets got modified to low- to moderate-carb diets, thereby leading to contemporary diets such as the moderate-carbs high-fat diet.

Sameer Chatterjee, a 43-year-old businessman from Kolkata, paid over Rs1 lakh for a seven-day "master cleanse detox retreat" programme at Atmantan luxury health and wellness resort near Pune. Chatterjee was used to a lifestyle that involved smoking, drinking and irregular food habits, and found out that he was pre-diabetic after undergoing blood tests before the programme. The diet required him to transition from solid foods to a zero-carb liquid diet. "Through the day, I was provided with sugarless cold-pressed juice and soup at regular intervals alongside massage and treatments," he said. "The only solids I had were salads on the first night and khichdi on the last." He went in overweight at 83kg, and came out lighter by 10kg. Unlike Chatterjee, Delhi-based Dr Gaurav Katyal, who is an anaesthesiologist and general manager, operations, at Indraprastha Apollo Hospitals, Delhi, has been maintaining his fitness without spending too much on his diet. "I count my calories and keep my macros—proteins, carbs, fats—in check," said Katyal. "My protein intake is around 1.2 to 1.4gm per kg of body weight, carbs are 2.4gm per kg and fats 1gm per kg." Katyal, 41, has always been conscious of what he eats and had quit smoking. "My energy levels are always high and I do not ever feel sluggish. At 72kg, my BMI is 22 and body fat is at 12 per cent and I feel lighter and fuller with a high-protein low-carb diet," he said.

A number of digital health care companies are using artificial intelligence to provide exhaustive weight loss plans, freshly prepared customised health meals and premium packaged foods and ingredients to the average Joe who is unable to take out time from a hectic corporate lifestyle to look after himself and his daily nutritional requirements. GetGrowFit.com has an entire weight loss collection that provides a free diet chart and additional nutritional consultation. From their Lean Machine Program to ultra low-carb vegan smoothies to an entire section on keto products, including customised keto flours and low-GI gluten-free flours, everything is a click or an app away. "People like to have everyday Indian food they are used to but tweaked with healthier options, like a low-carb biryani or a millet curd rice" says Jyotsna Pattabiraman, founder and CEO, GrowFit, where one meal a day for a week would cost Rs1,610 for vegetarian food and Rs1,750 for non-veg food. "Our keto range has been successful but 80 per cent of our customers come in for some kind of low-carb plan. About 30 per cent are interested in doing the full keto diet and 93 per cent see results in the first week, be it weight loss or balanced blood sugar levels."

Doctors concur that a balanced diet of protein, carbs and healthy fats works best for Indians. "There is a problem with a mindset that wishes to lose weight no matter what," said Johansson. "Because not all weight loss is good. When your goal is to shed body fat, preserve your muscle mass and stay healthy. Nobody wants to be frail, skinny and weak."