Dr. Anoop Misra drew back the flimsy curtain in his office, and the patient stepped down from the exam table, gently tugging the bottom of his shirt so as to obscure a considerable midsection. “I’m not here to give you sweet words,” said the soft-spoken endocrinologist, who, in addition to seeing patients six days a week at this upscale health center in New Delhi, chairs India’s National Diabetes, Obesity and Cholesterol Foundation. Dressed in a white lab coat and with neatly parted, thick gray hair, Misra reclaimed his position behind the desk and turned his attention to the patient’s wife. What does she cook at home, he wanted to know, and using what kinds of oil? “The diet is all fried,” said the doctor after the couple had gone. “This man is 62 and has already suffered a heart attack seven years ago.”
Across the lobby of the bustling facility, where women in saris and men in sandals sat beneath signs reading “Advanced Centre for Insulin Pump” and “Centre for Metabolic and Weight-Loss Surgery,” Shubhra Atrey, one of three clinical nutritionists who work with Misra, echoed her boss’s dismay. South Asians are genetically inclined toward an elevated risk of diabetes and cardiovascular disease, but in the seven-plus years she’s been practicing, Atrey said, she’s watched her fellow Indians undergo a transformation. “There’s more obesity, including childhood obesity, and we have seen that obesity causes more diabetes.” These days, she and her colleagues see some 60 obese patients every day. “We counsel them. Ninety percent of the time, we discuss about oils. Bad oil, good oil. Palm oil is not a very good oil.”
A 2017 study in The New England Journal of Medicine found that the global prevalence of obesity and excess weight has skyrocketed over the past 25 years, with more than 10 percent of the world’s population now considered obese. Some of the greatest increases have occurred in developing countries, many of which are also confronting epidemics of undernutrition. In India, noncommunicable diseases like diabetes recently overtook infectious ones like diarrhea and tuberculosis to become the leading killers. The Journal researchers pointed to the “increased availability, accessibility, and affordability” of high-calorie foods to explain the worldwide packing on of pounds. “We have more processed food, more energy-dense food, more intense marketing of food products,” Dr. Ashkan Afshin, the lead author, said upon publication of the study last June.
We also have more palm oil.
During the same years examined by the researchers, 1980 to 2015, global production of the oil, which comes from the bright-orange fruit of a tree that’s native to Africa, increased more than twelvefold, from 5 million to more than 62 million metric tons. As pointed out by the three Stanford professors who wrote the 2017 book The Tropical Oil Crop Revolution (Oxford University Press), the growth in production has surpassed that seen in wheat during the transformative period of the mid-20th century known as the Green Revolution. Walter P. Falcon, one of the book’s authors, lamented that the data on “food balance sheets”—the calories derived from various foodstuffs—are “pretty shaky,” but there is no question that the palm-oil boom has seen a flood of new calories entering the global system.