Blog Corner

Nirmal ~ “Ram Ban” for obesity or overweight prevalence in the US

Is the situation alarming with respect to obesity or overweight prevalence in the US? If you have any doubt, read below.

Let us start with Body Mass Index (BMI) first. A person with BMI of 25 or above is considered overweight and with BMI of 30 or above is obese. BMI calculation is simple. Someone who is 5'6" (5 * 12 + 6" = 66") and weights 160 lb has a BMI of BMI Calculation = [160 / (66 x 66)] x 703 = 25.8 <== This person is Overweight. See appendix too.

Out of all countries in the world, the US is ranked 9th with 74% of population (313 m) being overweight. In comparison, 2 most populous nations on the earth ~ China is at 148th rank with 28% of population (1.36 billion) being overweight and India at 176th rank with 16% of population (1.27 Billion) being overweight. See appendix for more details.

What is more disconcerting is that of all countries, the United States has the highest rate of obesity. From 13% obesity in 1962, estimates have steadily increased, reaching 19.4% in 1997, 24.5% in 2004,[4] 26.6% in 2007,[5] and 33.8% (adults) and 17% (children) in 2008.[6][7] In 2010, the Centers for Disease Control and Prevention (CDC) reported higher numbers once more, counting 35.7% of American adults as obese, and 17% of American children.[8]

According to a study in The Journal of the American Medical Association (JAMA), in 2008, the obesity rate among adult Americans was estimated at 32.2% for men and 35.5% for women; these rates were roughly confirmed by the CDC again for 2009-2010. Using different criteria, a Gallup survey found the rate was 26.1% for U.S. adults in 2011, up from 25.5% in 2008. Though the rate for women has held steady over the previous decade, the obesity rate for men continued to increase between 1999 and 2008, the JAMA study notes. Moreover, "The prevalence of obesity for adults aged 20 to 74 years increased by 7.9 percentage points for men and by 8.9 percentage points for women between 1976-1980 and 1988-1994, and subsequently by 7.1 percentage points for men and by 8.1 percentage points for women between 1988-1994 and 1999-2000."[9][10]

Obesity has been cited as a contributing factor to approximately 100,000-400,000 deaths in the United States per year[11] and has increased health care use and expenditures,[12][13][14][15] costing society an estimated $117 billion in direct (preventive, diagnostic, and treatment services related to weight) and indirect (absenteeism, loss of future earnings due to premature death) costs.[16] This exceeds health-care costs associated with smoking or problem drinking[15] and accounts for 6% to 12% of national health care expenditures in the United States.[17]

All references in the appendix.

Now what is “Ram Ban.” In Hindu mythology (84% of population in India follows Hinduism), Ram, a prince, represents the eternal good and use his Ban (meaning arrow) to kill Ravana, the epicenter of all evils.

So is this high time to consider obesity or overweight prevalence as an ‘evil’? And how ‘Nirmal’ could prove to be ‘Ram Ban’ for this all pervading evil which has potential to destroy our future generations.

We started in Oct 2009 with a goal of creating the first Indian food chain in the world by taking over an existing Indian restaurant named ‘Temptations’ at Ypsilanti, MI, incidentally 4 blocks down the first Domino’s Pizza store which started its operations in 1969. With history at our side, our task was cut out. 2 building blocks for an Indian food chain which we plan to focus on ~ how to take Indian food to the nook and corner and how to dispel various myths about Indian food as well as an Indian restaurant.

Our first aim took us to the 4 campus locations ~ 2 of them at University of Michigan, Ann Arbor. We were the first Indian food vendor to serve the food at the school cafeteria despite 15-20% of students being Asian (including Indians). We were instant hit at both locations. We have had contract with Aramark and Sodexho ~ 2 biggest food service providers in the US. In 2011, we opened our first franchise in Columbus, OH which is considered the food capital of US being home to Wendy, Bob Evans etc. Also we served at 6 corporate cafeterias in the South-Eastern Michigan in 2012. In 2012 we opened an independent satellite location at Wayne State University in Detroit without kitchen. For the 2nd building block, we ended up doing a ‘Fine dining’ restaurant with Full Bar at the central location with a lot of innovations like ‘Instant feedback card’ with awards, meticulous survey of our customers to improve our offerings and celebration of Indian festivals with much pomp etc which did not help us to expand customers’ base.

So after almost 4 years of trials and tribulations, we did almost U-turn dismantling the whole ‘Fine dining’ thing. We changed our venture name to ‘Nirmal’ (means Pure) to emphasize our new message and new business model of ‘Eat Healthy Drink Healthy.’ Please see our menu and ‘Many firsts’ at our website to gauge the difference.

Our goal still remains the same ~ to make an Indian food chain in true sense and now we have a mission to combat the ‘Overweight prevalence or Obesity’ in the US. We believe Indian food has potential to change the health profile of US in the long term. How? Also what at ‘Nirmal’ can play a role in our mission.

2 personal anecdotes during the last 3 years played a big role in this turn-around. One day I was reading an article with respect to BMI for us Indians which says for Indians, the waist circumference may also be considered for obesity or overweight calculation along with the weight and the height. Let me admit we Indians are not very fond of work-outs or gym whatever be the reasons. Just casually I asked my daughter (13 yr old) do you know what BMI is. She said yes one day her teacher made a passing reference but BMI is nowhere in the course-work. And she did not know how to calculate it. So I was shocked. Given the enormity of this problem and the present day awareness level of kids, I believe kids should start knowing their BMI at the age of 10 if not earlier. Then I started asking around in the guise of survey or some mundane discussion with our customers and it turned out that though most of the people have heard about BMI, only 10% knew their BMI or how to calculate it. So now at the very entrance of Nirmal, we put a ‘BMI chart’ which shows the calculation and other information. And it is at the back page of our main menu.

Second anecdote happened during our stay in a working class neighborhood in a Detroit suburb. My younger daughter (11 yr) had a friend named Katie (11 yr, white American, name changed) just across our house. So one day they have sleep-over at our house and we went together to Wendy to grab some food for them. My kids love chicken items, they ordered that (to be honest other meat they eat is goat, not available there). Katie did not eat Chicken and she ordered ‘Beef’ items. When I asked her why, she just mentioned their family mostly eat beef and pork, both strict no-no for us Indian Hindus. ‘Cow’ is revered in our religion and bringing ‘beef’ at the home that day was the first and last instance for us. So they switched to ‘cheese pizza’ for their subsequent sleepovers. But one question haunted me long after ~ did Katie’s family know that Chicken is much healthier than beef or pork? Specially kids in those families. This led us to put ‘Calorie chart’ for all types of meat in the menu as well as at Nirmal dining hall, please see below.

We believe and wish other restaurants to follow us at least in these 2 things. Whatever the people should eat they should know how their eating impact their health.

Indian food is central to our mission and it has 4 important components:

1. less red meat and dairy products consumption, No beef and pork in Indian cuisine due to religious beliefs, for example, Goat meat is our specialty, the healthiest meat even better than Chicken, and people here are not aware of goat meat, please see below:

Table 1. Nutrient Composition of Goat and Other Types of Meat [1], [2]

Nutrient Goat Chicken Beef Lamb Pork
Calories 122 162 179 180 175
Fat(g) 2.6 6.3 7.9 8.2 8.1
Saturated Fat(g) 0.79 1.7 3.0 2.9 2.9
Protein(g) 23 25 25 25 24
Cholesterol(mg) 63.8 76.0 73.1 73.1 78.2

2. ‘Curry’ based food, Curry is gravy made with some base like tomato, onion etc with spices, hence less meat and more intake of whole grain and vegetables, our spices have beneficial effects, 5000 years of history to back-up our claim and so many research going here in the US Universities

3. Lentils are staple food in Indian cuisine. That’s why despite India being the second largest producer (25% of world production), we consume all produce domestically. Incidentally Canada is the largest producer as well as the biggest exporter of the lentils. Also Indian food has lot of vegan and vegetarian options. Please see appendix for more info on Lentils.

4. Healthy substitute for soda and alcohol, our drinks (mango lassi, thandai, cumin drink etc) are healthy and have beneficial spices.

All these 4 things give us advantage over other Asian or Mediterranean cuisine. Read more in appendix.

Compare these characteristic of Indian Cuisine with the components of a healthy diet ~ less red meat, more grain and vegetables, less soda. So if people start eating Indian food even once or twice a week, basically they are eating the healthy food without being told or forced. Leave aside the nutritional aspect, the aroma and taste of Indian cuisine converts almost 60% of people into a loyal customer within 3 months. Specially we want kids in the schools and the college students to get exposed to Indian cuisine. During the last 3 years, we served food at the campus cafeterias as well as the corporate cafeterias. The college students (age 20-30) were more amenable to try our food and we were able to build a loyal customer base at the campuses. At corporate cafeterias (ages 35-60), we failed to build a customer base and it was not surprising for us.

Let us analyze some data ~ India has overweight prevalence of 16% as compared to 74% in the US and 28% in China. Some argue that the low rate in India may be due to the huge poverty as almost 30% of the population don’t have access to the proper food. Whereas the fact is, this 16% rate is due to access to multi-national fast food chains or rather recent culture of eating fast food among the higher income or rich populace mostly in the big cities in India. Just for example Domino’s Pizza now has 600 outlets in India, third highest in the world after US (4900) and UK (720) and that has happened in the last 5-6 years.

Compare the scenario with US ~ here overweight problem afflicts mostly low income, less educated and poor people. Rich or educated people have access to the healthy food which does not come cheap whereas poor or uneducated are left with options to eat hamburger, meat sandwich, potato chips or sodas which come cheap. We can provide much healthier options at very reasonable price. Specially as of now our customer base consists of 75% Americans (Caucasians), 18% Indians, 5% (other Asians) and 1.7% (African-Americans) and 0.3% (Hispanics) which represents more or less any Indian restaurant in the US. Our aim is to bring more African-Americans and Hispanics to try our cuisine as this population segment needs the affordable healthy food most.

What we have done so far and plan to do:

1. Products ~

a. To dispel the notion that Indian food is elite ~ introduced ‘lunch or dinner always in $5’, also introduced half orders for various entrées and Tandoori items making them affordable for low income populace as well as for the students.

b. To stop Americanization of Indian food ~ read less usage of creamy or dairy products. The use of excessive cream blocks the real taste and aroma of Indian cuisine. And the real benefits are also lost. We have made concerted effort to minimize the usage of dairy products. For example, instead of using ‘butter’ to spray our Naan bread (our bread is called Butter naan), we use ‘olive oil.’ In our daily menu, we offer mostly dairy free items. Let me admit while growing up in India, I used to have dairy products 3 times a day in our meal but in the form of yogurt for the morning breakfast or ending with a glass of milk in the night. But I never saw my mom or grandma to use ‘dairy’ products in our entrees or main course for the veggie or meat items.

c. Also we change our entrées daily intimating our patrons through twitter, facebook or our website. Idea is to introduce the diversity of Indian cuisine to our patrons and also to serve the items what we eat at our home. You won’t find items offered at Nirmal in any other Indian restaurant in Michigan or beyond.

d. Spicy Vs Hot ~ Indian food is all about spices, does it make it hot, NO. To make food ‘hot’ we use red chili powder. Very few spices are hot in itself, so if you order ‘mild’ food, we don’t use red chili powder at all. And you can get used to the ‘hotness’ of some spices after 3-4 outings. However ‘red chili’ has its own benefits and makes Indian food tastier.

e. Beverage ~ First we have plenty of Indian beverages like Mango lassi (yogurt drink), Thandai, Cumin drink, Indian tea (hot). Then we offer orange and apple juice along with 2% milk, a first for an Indian restaurant. Still if someone wants soda, we just provide 12 oz can. At Nirmal, 70% of patrons who opt for beverage go for other drinks. This could be one way of reducing soda consumption in the long term.

2. Messaging

a. To dispel the notion that Indian food is spicy, oily or messy. Our whole website is devoted to explain how Indian food is one of the healthiest foods around. We have put the data and the results from various research going on. Please see appendix.

b. In the restaurant we have put charts depicting the calorie values of our food (meats and meats’ substitute) and the very first chart ‘Know your BMI’ at the entrance makes our intentions clear. Also we want to wean people away from ‘Buffet’ which is not healthy eating at all. Please see appendix.

c. We use ‘bio-degradable’ products for service at Nirmal as we are a self-service restaurant now. We want people specially kids become aware of ‘green’ or ‘recycling’ at the younger age.

d. Overreach ~ Since 2010, we have taken our food to the various campus locations ~ 2 at U of M, Ann Arbor, one each at EMU, WSU and Adrian college along with 6 corporate cafeterias and have had contract with Aramark and Sodexo, the 2 largest food service providers in the US. We did very well at the campus locations whereas we failed at the corporate cafeterias. We deduced that it is easy to build or change certain food eating habits at younger age and we decided to pursue more campuses at the colleges as well as the schools.

e. Future ~ To become the first Indian food chain or restaurant in the US to have ‘drive-through’ and have own delivery network on the pattern of ‘Bombay dabbawala’ to extend our reach.

Please visit our website www.nirmalindiancuisine.com to access ‘appendix’ and for more info.

Our aim at Nirmal is to make Indian food a part of the regular meal for kids in the schools and young adults in the colleges and the low income populace who are more prone to succumb to overweight prevalence or obesity. Indian food with its spice content (curry based food) and our eating style (more grain, vegetable, less meat consumption) can stop this menace of overweight prevalence or obesity in the next 20 years in the US.

Restaurants (all types) are the place where almost everyone goes once or twice a week here in the US given the culture of eating out. We can convey our message subtly to the people specially younger ones as we have done at Nirmal. We owe this to our future generations.

(The author of this article, Priya Ranjan Dass, is an MBA from Ross School of Business, the University of Michigan, Ann Arbor and is the main driving force behind this venture since the beginning in 2009)