Editorial
James Joseph
Abstract
For 60 years since its founding, Kerala took pride as the number one state in the country on life expectancy, receiving praise from world renowned global health expert, professor Hans Rosling. Prof Rosling puts Kerala ahead of Washington DC on Human Health Index at a fraction of per capita income. However, lifestyle diseases like diabetes is now in the order of an epidemic in the state reducing the life expectancy of our adult population above the age group of 30. For the first time Kerala lost out its number one position on life expectancy to Jammu and Kashmir due to an alarming drop in life expectancy after the age of 30 compared to J&K as per 2010-14 census data. Root cause of our problem with diabetes and lifestyle diseases is the rapid increase of starch in our diet over the past 60 years through rice, wheat, and tubers like cassava. Through years of policy interventions we were able to make starch more affordable but the over correction is now hurting our health than helping it. In order for Kerala to get back and retain our number one position in life expectancy, we have to cut back our starch consumption from half a plate to a quarter and increase consumption of our grossly underutilized green jackfruits. This talk will scientifically explain why one of Kerala???s oldest traditions of eating green jackfruit as a meal is the perfect plate for diabetes and lifestyle diseases. The results from the first glycemic research conducted on green jackfruit at Sydney University, first randomized control trial on green jackfruit meal showing reduction in HbA1c are as follows. 1. Increased awareness from declaring Jackfruit as the State fruit in March 2018 and the one meal campaign increased consumption of green jackfruit meal during the season, April to June, with prices sky rocketing to Rs 20 ($ 0.3) per Kg for a fruit which was mostly wasted. 2. From April 2018 the record showed a decline in Anti-diabetes medicine sales in Kerala government pharmacies reaching a 25% drop in May and June compared to March. 3. After the Jackfruit season got over in July, sales started steadily increasing every month and by October it returned back to March 2018 level. 4. A review of three year sales record also showed month to month and year to year decline of medicine sales during the jackfruit season in 2018, while there was a month to month and year to year increase in sales after the season. Conclusions: The results clearly shows there is a definite relation between increased consumption of green jackfruit meal as an alternate to rice and reduced demand for diabetes medicine in Kerala during jackfruit season. And a rapid increase in Diabetes medicine sales when people switched back to rice after the season. This further shows the results already seen from the randomized control study on 36 patients can be reproduced on a larger population state wide. We now have a) internal product data to establish nutritional and glycemic advantage for green jackfruit, b) external interventional study on patients showing HbAa1c reduction with jackfruit meal and c) empirical evidence on reduction in demand for diabetes medication during jackfruit season. While Kerala is struggling to find a solution to contain its rapidly increasing health care costs and early deaths from life style diseases like type 2 diabetes, this study shows there is a significant opportunity to conduct a multi-center clinical trial on green jackfruit meal as an alternate to rice and formulate policies to use its mostly wasted natural resource, green jackfruit as a medical nutrition therapy like the Mediterranean diet recommended by ADA.