- Associated Press - Saturday, March 26, 2016

DAYTONA BEACH, Fla. (AP) - A citizen of the United States but a native of India, Dr. Dinesh Arab has seen the extremes of malnutrition, both the feast and the famine.

As a child in India, Arab could not believe there was a place where obesity could be an epidemic. In the United States, two-thirds of American adults have an unhealthy weight and half of Americans have one or more preventable chronic diseases, according to the U.S. Department of Agriculture.

“The biggest problem for me growing up was constant hunger,” he wrote in an essay about nutrition. “Even today, 195 million people in India go hungry every day.”

Malnutrition was something he treated regularly in his medical school in India.

“We would visit villages, to educate the population about balanced diets, and nutrition,” he said. “The scenes in some of these places were akin to the concentration camps I had watched in movies. Most of the pediatric admissions were because of starvation.”

Arab experienced malnutrition himself when he was young, losing a tooth to a calcium deficiency. The tooth broke apart while Arab was biting into an apple. When he moved to the United States, he got his teeth capped.

He now treats conditions often related to overeating, such as heart disease. Arab is a cardiologist at Florida Hospital Memorial Medical Center.

The abundance of food is a good problem to have “because at least you don’t know what hunger is,” he said in an interview.

But whether it’s “obesity or hunger,” they are variations of the same, he said.

“They (both) lead to medical problems which are ultimately life threatening,” Arab said. “Prevention is what it’s all about.”

“Once you have (a chronic disease), there’s no cure for half of this stuff,” Arab said. “There’s no cure for diabetes. There’s no cure for hypertension. There’s no cure for heart disease. We just control it.”

March is nutrition awareness month. Arab said the latest trend in nutrition is to get people to eat less processed and refined carbohydrates, such as pasta, white bread and white rice.

Arab also advises people to watch their sugar intake. The American Heart Association recommends limiting sugar to nine teaspoons a day for men and six teaspoons a day for women. This does not include the natural occurring sugar that is found in fruit or yogurt.

Arab who calls himself a foodie, considers pizza and chocolate as rare treats rather than daily staples.

“I love chocolate,” he said. “If I eat it, it’s going to be good chocolate. I won’t waste the calories on candy bars.”

Angela Sterrett, a dietitian and diabetes educator at Florida Hospital Memorial Medical Center, said portion control is a big problem for people trying to manage their weight.

“We’ve been supersized out of knowing what a portion is supposed to look like,” she said.

Sterrett said a healthy, single serving of refined carbohydrates would be about a third of a cup for an adult.

“It’s not the amount of pasta at the Italian restaurant or the amount of rice at the Chinese restaurant,” she said.

People are also not eating enough fruits and vegetables, “what I call rabbit food,” Sterrett said.

“So many of us are meat-and-potato eaters,” Sterrett said. “We don’t think that the half the plate needs to be fruits and vegetables.”

Sterrett said also people eat too fast, not giving their bodies time to digest and feel full.

“It really does take your stomach 20 minutes to signal your brain that you have had enough to eat,” she said.

“If we eat really fast, we can demolish a Thanksgiving dinner and dessert in 20 minutes,” Sterrett said. “Most people just shovel it in before they realize they should have had some satiety factors (or feelings of fullness).”

Sterrett also acknowledged that losing weight is never easy. Food addiction is especially difficult.

“That’s a hard one to deal with because you can quit smoking or you can quit drinking but you can’t quit eating,” Sterrett said.

Peggy Nichols, a graduate of Sterrett’s nutrition class, once weighed 213 pounds with a height of 5 feet 4 inches. The 66-year-old has since dropped 80 pounds in 10 months, mostly by walking more, cutting down on carbohydrates and being more mindful about what she eats.

Nichols said a diagnosis of diabetes was a “godsend” because it made her realize she had to lose weight. She is glad she did it.

“It’s so amazing how you feel,” Nichols said. “I walk a mile a day, before I couldn’t walk 20 feet. I just have a lot more energy. When the weight came off, it was like, ‘Wow.’”

Nichols has changed how she looks at food.

“I used to love my butter, my Italian bread, my pasta,” Nichols said. “I look at that stuff now and think, ‘Oh, no.”

___

Information from: Daytona Beach (Fla.) News-Journal, http://www.news-journalonline.com

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