sustainable food

You don't have to feast on meat to get your protein

Hidden proteins in foods that are not part of full meals often double a person's protein intake.

Andrew Taylor has eaten only potatoes for a whole year. Well, almost. He made his diet more nutritious by including sweet potatoes, and adding nut or soya milk to mashed potatoes. He also avoided vitamin B12 deficiency by taking supplements.

His cardiovascular health appears to have improved over the year, largely due to massive weight loss (50kg). He has cured his anxiety and depression, sleeps better and says he is fitter and healthier than he has ever been in his adult life. However, at the beginning of the year-long challenge, there was much debate among dietitians and nutritionists about whether he would get enough protein from his potato diet.

In the UK, healthy adults are advised to eat 0.75g of protein per kilogram of body weight each day. However, this “reference nutrient intake” is set at a high level to meet the needs of just about everyone in the population. Most people need less than this, and the average requirement is about 0.6g per kilogram of body weight (that is, 60g for Andrew’s current weight of about 100kg). Andrew ate about 3.5 to 4kg of potatoes per day, and together with the soya and nut milks used to mash the potato, it looks as though he managed to meet his protein requirements.

Good for the planet

Although combating global warming may not have been the primary reason for his challenge, Andrew has done his bit for planetary health. Agriculture’s greenhouse gas emissions are on the rise, with the largest source being methane produced by livestock. The agricultural sector is the world’s second largest emitter (after the energy sector) and the biggest thing that we can do to reduce these agricultural emissions is to eat less meat.

Becoming vegetarian or vegan would not be an acceptable or achievable option for many people, but even aiming for a plant-based diet, and limiting meat consumption, would make a substantial difference. Scientific models have suggested that if average diets in the UK conformed to WHO healthy diet guidelines, it would reduce greenhouse emissions associated with food by 17%.

Further cuts in emissions could be made by adopting a “flexitarian” eating pattern with fewer animal products and more plant foods. This pattern is not unlike that suggested in the current Eatwell guide and the World Cancer Research Fund cancer prevention recommendations, and would have substantial health benefits as well as being good for the planet.

‘Hidden’ protein

But one barrier to reducing meat consumption is the belief that we need it to meet protein requirements. A low-protein, high-carbohydrate, plant-based diet contrasts with the dietary regimen currently promoted by the food and fitness industries. The public are encouraged to believe that their own diets are in some way lacking in protein, and that they need to focus on their protein intake to make up for some sort of deficit.

This is perhaps reinforced by the way that untrained nutrition “experts” translate protein requirements into food guidance. For example, they might quite correctly say that a healthy young man needs about 55g of protein per day. They then translate this into protein-containing foods, such as 100g steaks and 100g grilled chicken breasts, which each contain 30g of protein. What this doesn’t pick up on is the hidden protein in all the other foods eaten throughout the day.

For example, the following diet provides 2,500kcal of energy, enough for an average man. It also contains 136g of protein, more than twice the recommended amount.

Source: Dietplan7.
Source: Dietplan7.

It is not hard to meet protein requirements. A few groups of people may need proportionately more; for example, children, older people, anyone recovering from major surgery, pregnant women and some athletes. But even these groups would rarely need more than 1.5 to 2g of protein per kilogram of bodyweight per day.

Even without the meat and chicken, this sample diet would provide adequate protein and, since the protein is coming from a variety of sources, it would contain a good mix of amino acids. National diet and nutrition surveys in the UK indicate that we eat more than enough protein.

If you’re looking to cut down on your meat consumption, maybe you could become flexitarian or do meat-free Mondays. You will still manage to meet your protein needs. And if you have already made the move away from meat, there are other things you can do with your diet to reduce your environmental impact without taking the radical step of eating only potatoes.

The writer is a lecturer in human nutrition and dietetics at Glasgow Caledonian University.

This article was originally published on The Conversation.

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Removing the layers of complexity that weigh down mental health in rural India

Patients in rural areas of the country face several obstacles to get to treatment.

Two individuals, with sombre faces, are immersed in conversation in a sunlit classroom. This image is the theme across WHO’s 2017 campaign ‘Depression: let’s talk’ that aims to encourage people suffering from depression or anxiety to seek help and get assistance. The fact that depression is the theme of World Health Day 2017 indicates the growing global awareness of mental health. This intensification of the discourse on mental health unfortunately coincides with the global rise in mental illness. According to the latest estimates from WHO, more than 300 million people across the globe are suffering from depression, an increase of 18% between 2005 and 2015.

In India, the National Mental Health Survey of India, 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) revealed the prevalence of mental disorders in 13.7% of the surveyed population. The survey also highlighted that common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. Perhaps the most crucial finding from this survey is the disclosure of a huge treatment gap that remains very high in our country and even worse in rural areas.

According to the National Mental Health Programme, basic psychiatric care is mandated to be provided in every primary health centre – the state run rural healthcare clinics that are the most basic units of India’s public health system. The government provides basic training for all primary health centre doctors, and pays for psychiatric medication to be stocked and available to patients. Despite this mandate, the implementation of mental health services in rural parts of the country continues to be riddled with difficulties:

Attitudinal barriers

In some rural parts of the country, a heavy social stigma exists against mental illness – this has been documented in many studies including the NIMHANS study mentioned earlier. Mental illness is considered to be the “possession of an evil spirit in an individual”. To rid the individual of this evil spirit, patients or family members rely on traditional healers or religious practitioners. Lack of awareness on mental disorders has led to further strengthening of this stigma. Most families refuse to acknowledge the presence of a mental disorder to save themselves from the discrimination in the community.

Lack of healthcare services

The average national deficit of trained psychiatrists in India is estimated to be 77% (0.2 psychiatrists per 1,00,000 population) – this shows the scale of the problem across rural and urban India. The absence of mental healthcare infrastructure compounds the public health problem as many individuals living with mental disorders remain untreated.

Economic burden

The scarcity of healthcare services also means that poor families have to travel great distances to get good mental healthcare. They are often unable to afford the cost of transportation to medical centres that provide treatment.

After focussed efforts towards awareness building on mental health in India, The Live Love Laugh Foundation (TLLLF), founded by Deepika Padukone, is steering its cause towards understanding mental health of rural India. TLLLF has joined forces with The Association of People with Disability (APD), a non-governmental organisation working in the field of disability for the last 57 years to work towards ensuring quality treatment for the rural population living with mental disorders.

APD’s intervention strategy starts with surveys to identify individuals suffering from mental illnesses. The identified individuals and families are then directed to the local Primary Healthcare Centres. In the background, APD capacity building programs work simultaneously to create awareness about mental illnesses amongst community workers (ASHA workers, Village Rehabilitation Workers and General Physicians) in the area. The whole complex process involves creating the social acceptance of mental health conditions and motivating them to approach healthcare specialists.

Participants of the program.
Participants of the program.

When mental health patients are finally free of social barriers and seeking help, APD also mobilises its network to make treatments accessible and affordable. The organisation coordinates psychiatrists’ visits to camps and local healthcare centres and ensures that the necessary medicines are well stocked and free medicines are available to the patients.

We spent a lot of money for treatment and travel. We visited Shivamogha Manasa and Dharwad Hospital for getting treatment. We were not able to continue the treatment for long as we are poor. We suffered economic burden because of the long- distance travel required for the treatment. Now we are getting quality psychiatric service near our village. We are getting free medication in taluk and Primary Healthcare Centres resulting in less economic stress.

— A parent's experience at an APD treatment camp.

In the two years TLLLF has partnered with APD, 892 and individuals with mental health concerns have been treated in the districts of Kolar, Davangere, Chikkaballapur and Bijapur in Karnataka. Over 4620 students participated in awareness building sessions. TLLLF and APD have also secured the participation of 810 community health workers including ASHA workers in the mental health awareness projects - a crucial victory as these workers play an important role in spreading awareness about health. Post treatment, 155 patients have resumed their previous occupations.

To mark World Mental Health Day, 2017, a team from TLLLF lead by Deepika Padukone visited program participants in the Davengere district.

Sessions on World Mental Health Day, 2017.
Sessions on World Mental Health Day, 2017.

In the face of a mental health crisis, it is essential to overcome the treatment gap present across the country, rural and urban. While awareness campaigns attempt to destigmatise mental disorders, policymakers need to make treatment accessible and cost effective. Until then, organisations like TLLLF and APD are doing what they can to create an environment that acknowledges and supports people who live with mental disorders. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.