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Ask any gastroenterologist about the days after Diwali and the list is familiar: heartburn that wakes people at night, a distended abdomen, loose stools, and the occasional stomach infection traced to a sweet left out too long. The sweets are not villains. But the digestive tract is far from indifferent to how a mithai is made, how much is eaten and when.
Most advice on festive sweets rests on calories. That is incomplete. The gut responds to fat, to lactose, to fermentable carbohydrates and to the timing of a meal, and a calorie count captures only some of that.
What The Gut Notices
Fat
Dietary fat slows gastric emptying, so food lingers in the stomach. High-fat meals are also associated with more frequent transient relaxations of the lower esophageal sphincter, the muscular valve that keeps acid where it belongs. The consequence is reflux. A fried sweet in syrup, eaten late at night, is close to a textbook trigger. In people with gallstones, a large fatty load can also provoke a gallbladder attack.
Lactose
By most estimates, a majority of Indian adults digest lactose, the sugar in milk, poorly. Khoya is milk reduced by prolonged heating, which concentrates its lactose. Chhena is curdled milk from which much of the whey, and the lactose dissolved in it, has been drained. Undigested lactose draws water into the bowel and is fermented by colonic bacteria, producing gas, cramps and diarrhea.
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Fermentable Carbohydrates
Chickpea flour and cashews both contain oligosaccharides, which ferment in the colon. In people with irritable bowel syndrome, larger portions can aggravate symptoms.
Sugar
The World Health Organization recommends that free sugars supply less than 10 percent of daily energy, with additional benefit below 5 percent: about 50 grams and 25 grams on a 2,000-calorie diet. Sucrose is half fructose, which is metabolized largely in the liver, where excess promotes fat synthesis. That matters in a country where metabolic dysfunction-associated steatotic liver disease, formerly called fatty liver disease, is estimated to affect roughly one in three adults.
A Sweet-by-Sweet Reckoning
Mithai Approx. Energy Principal Digestive Considerations Relative Gut Burden
*Energy values are indicative and vary with recipe and portion. The final column is a clinical judgment about typical preparations, not a measured quantity.
The ranking is comparative. A single rasgulla is not a license to eat four. Portion and timing alter every row of this table.
The Risks Outside the Box
Festive demand strains supply, and gastroenterologists see the consequences in the form of gastroenteritis. Milk-based sweets spoil quickly, especially when left unrefrigerated through an evening of visitors. Adulterated khoya is a recurring concern in the festival season. Buy from licensed vendors, check the date of preparation, refrigerate milk-based sweets and discard anything that smells sour or looks discolored.
How to Eat Mithai
The evidence favors modest, unglamorous habits.
- Eat sweets after a meal, not in place of one. Skipping meals to "save room" tends to end in overeating and acid.
- Plate one portion. Grazing from the box makes it easy to lose count.
- Finish dinner early. Guidelines for gastroesophageal reflux disease, including the American College of Gastroenterology's 2022 guideline, suggest avoiding meals within two to three hours of bedtime in people with nighttime symptoms.
- Take a short walk. Light walking after meals modestly lowers post-meal blood glucose in trials; its effect on acidity is less well established.
- Hydrate, and ease off alcohol, strong tea and carbonated drinks, which can aggravate acidity.
- Keep fiber in the day. Fruit, dal, vegetables and whole grains guard against the constipation that rich festive food brings.
People with diabetes should count the carbohydrate: jaggery, honey and dates are still sugars. Sweets made with sugar alcohols, often marketed as sugar-free, commonly cause gas and loose stools. Those with reflux should avoid fried sweets late in the evening, and people with gallstones or high triglycerides should be wary of large, fatty meals.
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When It Is Not Just Indigestion
Mild discomfort after a rich meal usually settles on its own. Persistent or severe symptoms do not, and the following warrant prompt medical attention: severe or lasting abdominal pain; repeated vomiting or vomiting blood; black, tarry or bloody stools; difficulty or pain with swallowing; unexplained weight loss; and diarrhea lasting more than a couple of days.
There is no single healthiest Diwali sweet, only better and worse bargains for the digestive tract. For most people, a small piece of kaju katli or a rasgulla with the syrup drained will be easier on the gut than a fried, khoya-heavy sweet. But portion, timing and food safety shape the outcome more than the choice of mithai itself. Choose what you love, eat it slowly and early, and let the festival be a festival.
(By Dr. Sukrit Singh Sethi, Director & Senior Consultant - Gastroenterology, Hepatology & Liver Transplantation, Narayana Hospital, Gurugram)
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