Friday 5 March 2021

How much can you trust Bollywood’s favourite dietician Rujuta Diwekar?

 Celebrity dietician Rujuta Diwekar stirred up a Twitter row last month when she said mangoes are safe for diabetics. It was yet another of her many contentious claims.

If you’ve Googled “how to lose weight” in India, a name you would not have missed in the results is Rujuta Diwekar.

The celebrity nutritionist with a glittering clientele such as Kareena Kapoor and Anupam Kher, is the author of the popular book Don’t Lose Your Mind, Lose Your Weight. Diwekar also has a formidable online presence —her Twitter followers and YouTube video views are both in excess of half a million.

Celebrity nutritionist Rujuta Diwekar (centre) has a glittering clientele | Commons

The 44-year-old’s emphasis on cooking locally available produce, exalting “Indian food the way your grandmother cooked them”, advocating counting pranic value (which she classifies as freshness of food) instead of calories, while also citing new American research on heart disease and using WHO statistics to back sugar consumption, have earned her admirers across the spectrum.

But her ideas have also drawn as much flak as they have followers as Diwekar has earned the ire of doctors, nutritionists and researchers.

On 30 April, Diwekar, who came into prominence in 2008 for helping Kapoor achieve a “size zero” body for the movie Tashan, created a stir when she recommended mangoes for diabetics, tweeting that the fruit is seasonal, local and low on glycemic index (GI).

It angered medical professionals, who termed the advice dangerous.

But such is her following, Diwekar was swiftly defended, with many of her followers pointing to the fruit’s relatively low glycemic index.

Responding by email to queries from ThePrint, Diwekar said that her recommendation was based on one from a doctors’ body. 

“Mango and its effect on blood sugars — it’s from the Association of Physicians of India, Karnataka chapter. One of the objectives of this study was to get diabetics to consume fresh, local fruits without fear,” she said.

She also stressed that her statements are based on available research. “Every idea that I talk about or tweet has been in the public domain for over a decade. A cursory Google search will help you find articles from authoritative journals that back that information,” she said.

Lack of context

Technically, Diwekar’s statements are often correct. Mangoes do have a lower GI but her throwaway advice, say medical experts, lacks the larger context of portion control and total sugar consumption. Mangoes aren’t just sugar; they’re full of nutrients. But mangoes aren’t just nutrients either; they’re also full of sugar.

“It is highly incorrect to make recommendations for any food item solely on the basis of GI,” explained Maaz Shaikh, the co-founder of Wellthy therapeutics, India’s first digital therapeutic firm managing thousands of diabetics every day. “For a diabetic, what matters most is the glycemic load — total amount of sugar that enters their system.”

So, the problem is not a diabetic patient eating mangoes, it is not knowing when to stop.

But Diwekar not only avoids mentioning portion control in public, she seemingly advocates against it, saying in this interview, “We are born with the ability to self-terminate eating; we do not need a dietician or a doctor to tell us where to stop.”

To her credit, that’s not entirely wrong.

“All animals do have checks and balances that keep them from overeating,” explained Ishi Khosla, clinical nutritionist at the Centre For Dietary Counselling, Delhi, and founder of The Celiac Society Of India. “The perfect example of this is how you can never overfeed a baby or a pet. But that is provided they aren’t exposed to sugar or junk.”

But sugar changes everything.

All about sugar

Diwekar’s assertions on sugar are contentious, to say the least. Her new book, ‘Indian Super Foods’, lists sugar as one. In a fiction vs fact table, she terms the medical advice to “avoid sugar if diabetic” as fiction and claims that meta studies have shown no “conclusive link between consumption of sugar and diabetes”. 

Diwekar also claims that refined sugar and jaggery are healthier than beet sugar.

“Most forms of sugar are converted to glucose in the body,” explained Shaikh. “Simple sugars like our everyday white sugar spike our blood sugar levels very fast while more complex sugars lead to slower rise. Sugarcane, jaggery, beet sugar are all simple sugars that are absorbed rapidly and spike blood sugar levels.”

In her book, Diwekar claims low-calorie sweeteners can cause cancer — a claim heavily debunked. Her advice, particularly on Twitter, where her words reach more than 5 lakh people, doesn’t explain the complexities of nutrition nor does she cite authoritative sources.

Links she provided to ThePrint backing her statement on sweeteners (like hereherehere) all demonstrate older studies on rats. Today, even the most conservative of studies show that the mechanism of increased cancer incidence can be seen only in rats. It is non-reproducible in human physiology and artificial sweeteners were completely delisted from carcinogen lists in 2000.

She often proclaims that microwaves are harmful as micronutrient bonds “break, get oxidised, become toxic”. This myth has been refuted again and again; nutrients are best preserved when cooked fastest and microwaves are more suitable for that than low flames.

Her links to back these statements  (like this 1992 study, this study on any form of heating on garlic, this 1995 paper on milk, and this self-critical piece on microwave plastic) are at least 10 years old.

Diwekar uses the age of the studies to validate her stance without recognising that all of it is very much outdated, replaced today with better products and safe results.

“People who follow me on Twitter are intelligent and don’t take anything at face value. They arrive at their own decisions on food,” she said. “All I hope for is that one arrives at them based on facts and not fears.”

Unfortunately, Diwekar’s factually incorrect statements appear alongside sensible advice — like responsibly reducing plastic — increasing the credibility of her words.

Eat-local, the business model

Much of Diwekar’s appeal lies in her emphasis on consuming locally available produce and relying on our grandmothers’ cooking techniques. Her USP is simple: Stick to Indian foods the way our grandparents ate them.

Diwekar backs her claims on what our “ancestors” ate without details or context of the evolution of food. A whole host of vegetables that are staple today, including potatoes, tomatoes, and capsicum, came to India just 400 years ago. Apple came to India a little under a century ago.

“Our dadis, nanis seem to be eating whatever they like. They have great skin and look good even today. What are they doing that we aren’t?” she asks. The answer is obvious: No processed foods, sugar and junk that surround us at every corner. It’s not what they eat, it’s what they don’t.

Her standard recommendation to everyone, even those with diabetes and blood pressure, is eating rice, dal, and ghee every day.

“A lot of her advice on ‘traditional’ foods doesn’t apply to people who don’t belong to educated, upper-caste elite,” said Dr Veena Shatrugna, former deputy director and head of the Clinical Division at the National Institute of Nutrition.

Even today, the majority of the country simply cannot afford to eat rice, ghee and dal every day. “A large part of the working class eats rice with chutney or roti with onions. On the ground, it is important to not straddle class and social layers with sweeping statements,” added Shatrugna.

Diwekar also advocates for simple changes that are mostly just common sense and non-specific: Exercise every day, eat in short intervals for blood sugar stability, avoid packaged foods, eat healthy fats, cook foods we understand.

“Brazil is in this area,” she told ThePrint. “Their official dietary guidelines reflect the current space that nutrition science is in — eating is a social act, we should eat traditional and home cooked food (to account for diversity in cuisines and climate), and pay attention to food while eating to guide us on quantities instead of fussing about portion size.”

Nutritionist or dietician?

Diwekar’s words have impact and reach for a reason: There is a dearth of voices on nutrition, particularly from medical professionals.

“I would heavily fault doctors,” said Shatrugna. “Most have abdicated nutrition entirely. They advise diabetics to stop eating sugars and carbs like rice and meat, but don’t tell them what to eat instead. So, patients turn to nutritionists who are often without medical training, and whose important science isn’t seen as academic or useful by doctors.”

It is this void that Diwekar has tapped into efficiently. A lot of people whose troubles need to be controlled by diets don’t really know what to eat, so they turn to whoever has advice.

“Nutritional advice can apply to someone who’s hale and hearty and wants to lose weight at best,” said Dr. Kamini Rao, IVF specialist and founder of Milann Centre for Reproductive Medicine.

“Anyone with even the slightest of diseases requires personalised advice. Everyone with the same disease can’t be bunched into one group. Nutrition cannot replace medical advice, and it isn’t safe to recommend foods online to those with diseases,” she said.

In India, dietetics and nutrition aren’t well regulated. While the field of nutritionists is pretty much unregulated in most parts of the world, being a dietician requires a licence in several countries. 

But not in India, where the two words are used interchangeably.

“Nutrition is something everyone is waking up to today. It’s an evolving science that is often accompanied by a lot of sensationalism,” explained Khosla, a clinical nutritionist.

“Unfortunately, there is no prerequisite for a nutritionist in India today. People with a personal weight loss story or even marketers of nutritional supplements can call themselves a nutritionist.”

That isn’t good news for those seeking advice online, which is pretty much most of us.

“In the battle of your research vs mine, common sense, experience and practicality wins,” Diwekar told ThePrint. 

“Thanks to the internet, we are demanding more transparency about food research, asking questions of who funds a study, and if this affects the conclusion it arrives at.”

Like Diwekar herself seemingly agrees, words of celebrity nutritionists — especially in non-professional consultations — perhaps need to be taken with a generous helping of salt.

(Source: The Print)

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