I often get asked why South Asians need to significantly cut back on their rice intake to help them achieve optimal health.  After all, rice has been a traditional part of the South Asian and East Asian diet for generations. 52

I want to start off by saying there is nothing intrinsically unhealthy about rice other than the fact that it is a high glucose, high energy food that is meant to fuel active humans. If your activity levels are compatible with the amount of rice you consume and if you are not showing signs of insulin resistance, then rice is probably fine for you.  Unfortunately this is rarely the case in today’s world.  Below I have highlighted why this is a problem. Keep in mind that once individuals improve their body composition and increase activity levels, they can typically consume controlled portions of rice, ideally after periods of physical activity rather than after marathon sitting sessions.

Rice For Rickshaw Walas Only

One of my childhood memories during my summer trips to India was standing on the balcony of my father’s old house in Kolkata, looking down at the rickshaw walas (rickshaw pullers) who congregated in the alley below for meals, showers, and social gatherings.  These were the original human-pulled rickshaws, before the days of the modern auto rickshaw.  Every meal these men ate consisted of a giant mountain of rice and lentils.  The rickshaw wala physiques were mostly emaciated or lean.  If they had adequate access to protein, there’s no doubt they would have had ideal, muscular physiques.  I was mesmerized by their superhuman strength, carting around overweight families for long distances or carrying enormous bundles of cargo. Rice and lentils were necessary to fuel their body’s tremendous physical demands.

Today, human-pulled rickshaws are nearly obsolete and have been replaced by motorized rickshaws (auto rickshaws).  As a result, auto rickshaw drivers are significantly more overweight than their predecessors because they continue to eat a carb-heavy diet, but the nature of their job has abruptly turned sedentary. Unless you are pulling rickshaws all day, carrying heavy pieces of luggage as does a porter in a bustling Howrah train station in Kolkata, or laboring in the fields, your body doesn’t require the tremendous amount of glucose fuel you are consuming in the form of rice, lentils, breads, noodles, etc. The South Asian belly is direct evidence of this unnecessary surplus fuel.

Large servings of rice and lentils act as high-energy foods designed for bodies in constant motion. Our ancestors were constantly on the go, walking over 20,000 steps daily, engaging all muscles with daily physical labor, soaking in vitamin D from the sun, getting adequate sleep and rest between periods of intense work without 24/7 digital distractions, living in a more natural food environment uncontaminated by processed foods loaded with trans fats, high fructose corn syrup, and a plethora of other chemicals and additives.

If you can recreate anything close to this traditional lifestyle, then yes…you can probably handle the high glucose energy effects of rice, breads, and noodles with less trouble than a less active person can. It’s still not healthy to fuel your active lifestyle with pro-inflammatory carbohydrates.  The amount of glucose fuel you are putting in your body is meant for a race car that is moving full speed around a track all day, not for an oversized mini-van parked in the garage most of the time. And yes, in our current state we are the oversized mini-van.

The same foods, such as rice and noodles, have a completely different metabolic and physiological effect when consumed in today’s artificial environment than when consumed in the natural environment we used to live in (and were meant to live in).

I realize it is not practical in today’s world to recreate this situation exactly, but it is possible and absolutely necessary to take a few steps back and incorporate at least some of these traditional principles, while adjusting our fuel source (carbs) downward to be more compatible with our current lifestyles and activity levels.

Ronesh Sinha, M.D. is the author of  “The South Asian Health Solution,” a culturally tailored book on health for South Asians. He is a physician for the Palo Alto Medical Foundation who sees high risk South Asian patients, he blogs at southasianhealthsolution.org, and  he co-hosts a South Asian radio show on health.

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