To be healthy and fit, what should you eat and what should be cut from your diet? To this important question there are no dearth of ‘answers’ on YouTube and Instagram from various social media influencers, vloggers and self-proclaimed nutritionists. From weight loss and diabetic diets to foods that balance your hormones and ‘completely cure’ PCOS, there is a solution to everything they’ll have you believe. And this has led to many people landing up in hospital after following these generalised diets without consulting a doctor.
Trained dieticians and senior nutritionists caution that there is no single diet that fits everybody, and that diets need to be tailor-made for a person depending on their medical diagnosis.
“There is a difference between technical diet planning and generalised diet planning. Qualified nutritionists plan diets technically, while keeping the condition of the patient in mind,” says Dr Janaki Srinath, Senior Nutritionist and National Executive Committee Member of the Nutrition Society of India.
She further adds that if they are providing a special diet plan for weight loss to patients, they integrate key nutrients within a particular calorie band and recommend a diet accordingly. “We don't irrationally focus on weight loss. I'm trained to keep facts in mind about body composition and what is required in weight loss. We focus more on fat loss, and retain the muscle and bone mass. I also keep the general nutrition requirement of the person in mind, it is only then the ultimate objective of weight management is achieved. But often what is happening is that people only look at how quickly they can lose weight,” Dr Janaki adds.
On September 10 this year, Dr P Sudhir, President of the Indian Medical Association of the Warangal chapter approached the Mattewada police station in Warangal and filed a complaint against a nutritionist named Veeramachineni Ramakrishna for allegedly prescribing a generalised Keto diet plan to diabetic patients. This apparently had disastrous effects, leading to some of the patients losing consciousness and having to even be admitted to the ICU.
The Keto diet plan, allegedly prescribed by Veeramachineni, has been popular for a few years now and is a viral fad that has been popularised on social media and television channels. The Keto diet is a high-fat, low carbohydrate diet where the drastic reduction in carbs puts the body in a metabolic state called ketosis. Veeramachineni is also known for his comments against allopathy medicine.
Dr P Sudhir explains to TNM that there is no generalised diet plan to cure a particular affliction, and that they have to be planned depending on the patient. “When all the diabetic patients are following this diet, it can be dangerous. I know some people who have recovered from diabetes after following this diet, but the thing is, it should not be a blanket diet for everybody, because there are also people who have severely fallen ill after following a Keto diet plan,” says Sudhir.
Sudhir points to the case of 45-year-old Alivelu, who has diabetes and hypertension. She allegedly followed Veeramachineni’s diet plan and later on suffered from diabetic ketoacidosis, a serious complication of diabetes that takes place when the body produces high levels of blood acids called ketones, and had to be admitted to NIMS Hospital, Hyderabad. It took a month of treatment for her to recover. Alivelu has also filed a complaint at the Mattewada police station against Veeramachaneni, according to reports.
In this context, Sudhir questions what the government is doing to curb unethical diet prescriptions and the social responsibility of channels in airing such programmes without proper verification.
With their fun and compelling way of talking, social media influencers draw in their followers, and if they are promoting a particular product, brand or even a diet, many of the followers believe them without any questions. But experts say it should be kept in mind that a diet that works for a particular person, may or may not work for everyone.
“YouTubers and social media influencers are effective communicators. They communicate in an appealing way and with their skills in presentation, video making, editing, they can create a mass appeal and connect with people. Often, it's like storytelling, they talk like a neighbour or friend and make people think they know what they are talking about and ask you to try what they are promoting or selling,” Dr Janaki points out.
When an influencer has millions of followers and is popular, the public tends to treat them as experts. A YouTuber who runs a popular food vlog might be known for their recipes, but then they start talking about diet as well and what to eat and what to avoid. A fashion influencer on Instagram may have lost a lot of weight suddenly and will tell followers about what diet they’ve been following. Followers lap this information up. “People also think diet, food and fashion are closely linked,” adds Dr Janaki.
But doctors say that, with every day, this is becoming more challenging as many patients come to them with various issues after following these diets, “Each person’s metabolism, genetic risks, health profile is different, and the purpose of dietary treatment also differs from person to person,” the doctor adds.
“I always tell my patients not to follow any vague diets that they hear about on television and social media. I am seeing patients who avoid salt completely after listening to diet advice on television. There are dire consequences to this, if our intake of salt is near zero, sodium levels in the body will plummet and the person could need to go to the ICU. I have seen such patients. We shouldn’t follow anyone blindly,” says A Usha Sri, senior nutritionist at the AIG hospital in Hyderabad.
She further adds that there are also recommendations telling people that they should drink more water, and how many litres a day. This doesn’t work for everyone and can prove lethal to some heart and kidney patients depending on their health condition.
“For instance, kidney patients who have had kidney stones should drink a lot of water. However, patients who have had high creatinine levels due to which their kidney function has been damaged should not drink a lot of water, as it further damages their kidneys. Each case is different and after clearly identifying the problem only it should be treated and diet should be prescribed,” adds Usha Sri.
She also talks about the protein-rich diet that is popular among people. “After proper analysis of the kidney patient only should it be decided how much protein they need. Some patients who have chronic kidney issues and who have high protein intake without enough carbs might develop severe health complications and might be put under dialysis and suffer sepsis (severe infection),” adds Usha Sri.
Doctors say that in their day-to-day practice they have also seen patients who are overdoing it when it comes to millets. Many people who want to lose weight switch to millets as a carb source. “They do not know how to use millets and they over do it. Because of its high fibre content it can lead to gastric erosion, and reduce the bioavailability of many important nutrients and micronutrients,” says Dr Sunitha Premlatha, Chief Dietician, Yashoda Hospitals, Hyderabad.
“A diet depends on the individual patient, it is not a general thing. If you take insulin for diabetes, your diet will be different from someone who is taking medicines for hypertension. Likewise, if a patient had diabetes and hypertension the diet plan changes and if a patient had diabetes, hypertension, and kidney disease the diet will be different and very strict. For example, a person with kidney issues can’t absorb a lot of protein and should consume less of it,” explains Dr. Premlatha.
She further adds that several diets having fancy names are gaining popularity as people want to lose weight quickly and are desperate and willing to try whatever new fad diet is out there, without considering the long term impact it will have on their health. “People are easily attracted to new diet plans as they want quick results. They don't look at the long term health issues and expect results in a month or two. As these sound fancy, people follow them, but when we talk about science, that is less appealing,” says Premalatha.
Premlatha further says that diet always has to be individualised and tailor-made. “A qualified dietician will talk to their patient, they will check lab test results, consider age, and take body measurements before charting a diet plan,” says Dr Premlatha. It is also important to note what foods the patient has been eating all their life and depending on the financial position and cultural background, the nutritionist will suggest simple dietary changes they can incorporate.
However, various influencers recommend diet plans, which include, exotic fruits , vegetables and grains. Things like quinoa, avocados, dragon fruits, broccoli, and other things. “Not everybody can afford them. It should also be given a thought as to whether it is really required to eat a food you are not used to and if you should spend money buying it. Instead you could just stick to simple food from your kitchen,” adds Premlatha.
She further says that a diabetic diet is also not that different from what a regular family eats, “It's the same food in a more disciplined way, timing and quantity is important. When you come to a dietician, you will know why it is important. We don't usually recommend anything a person isn’t already used to. When people say they are going gluten-free, I wonder why? We have been eating rotis and rice for ages, it's our staple food. Why do you want to avoid it?” asks Premlatha.
Meanwhile, Dr M Yadagiri Rao, a diabetologist and former secretary of Indian Medical Association, Telangana, says, "If a particular diet is suggested, it is mainly based on the person’s weight, height, body mass index (BMI), and other profiles. If a person is 10 kg more than they should be and need to lose weight , the qualified doctors would suggest diets so that in a week only a kg of weight would be decreased rather than trying to decrease 5 kg or 10 kg in a week. The diet suggested will have a scientific base."
Experts caution people to not blindly follow celebrities and influencers’ advice on things they have no experience or expertise in. “Do not believe quacks, those who do not have any qualification to prescribe diets and recommend diets on social media. Such suggestions should be avoided,” adds Dr Usha Sri.
Instead they say to please consult doctors who are qualified, who have done their studies in nutrition, and have clinical experience.