June 14th 2021, India: Concerned about the increasing susceptibility of India’s youth to lifestyle diseases like cancer, diabetes, uncontrolled hypertension and cardiovascular diseases, scientists experts and doctors have written to the Food Safety Standards Authority of India (FSSAI), urging them to take responsibility for the consumer and impose scientific and globally agreed ‘cut offs’ on nutrients of concern in all packaged and processed food. The signatories are part of Nutrition Advocacy in Public Interest (NAPi), a think tank consisting of technical experts, academicians, administration, medical and public health professionals working on nutrition policy in the public interest for the past five years.
The letter is the outcome of a webinar held earlier this month where the findings of the recently conducted Comprehensive National Nutrition Survey data were discussed. The survey revealed that among children between 5 to 19 years of age, 56% had cardiometabolic risk factors, with similar prevalence in those who are believed to be undernourished: thin-54% and stunted-59%.
One astounding fact that came up was that more than 5.8 million Indians die every year from Non-Communicable Diseases (NCDs) or lifestyle diseases such as cancer, diabetes, uncontrolled hypertension and cardiovascular diseases. These deadly diseases are difficult to treat, but can be easily prevented by modifying diets and supporting a healthier, sustainable food system. With the growing Indian economy, the consumption of packaged foods, high in sugar, salt and bad fats, is seeing explosive growth, even in rural areas, across all socio-economic groups in the country.
“If these alarming signals are ignored now, India will pay heavily with a very large wave of Non-Communicable Diseases (NCDs) that will attack this generation of children as they grow into adults. Front-of-the-Pack-Labelling is one of the recommended core interventions to mitigate this alarming situation. Several countries including Brazil and Mexico have utilized the World Health Organization’s (WHO) recommended ‘cut offs’ for nutrient profiling to come up with the easily understandable front of pack labelling for packaged food with high fat, sugar, and/or salt (HFSS) content,” the letter, signed by Keshav Desiraju, Former Health Secretary, GOI and Chairman of NAPI as well as other senior members of the organisation, said.
While requesting for a policy change where “Front of pack labels on packaged foods with more than one ingredient should be based on the WHO recommended thresholds as these are being used worldwide,” the organisations also expressed its belief that food safety for consumers of packaged foods should be assured through appropriate packaged information based on relevant evidence instead of the marketing-based influence of the food industry.
NPM is a scientific method for categorizing food and beverage items according to their nutritional composition and is developed to moderate consumption of sodium, saturated fat and added sugar. The NPM translate these goals into specific food and beverage targets and helps identify and differentiate foods that are unhealthy (high in salt, sugar, and/or saturated fats). Based on the “cut off” established by the NPM, the front-of-pack label informs consumers whether a product contains excessive sugar, sodium and saturated fat.
Recent data showed that ultra-processed foods are quickly taking over the dietary preferences and buying decisions of consumers in India, leading to unhealthy and dangerous eating habits. Analysis of sales data* reveals that per capita sales of ultra-processed foods grew from about 2 Kg in 2005, to about 6kg in 2019 and is projected to grow to about 8 kg by 2024. Similarly, ultra-processed beverages are up from 2 L in 2005 to about 6.5 L in 2019 and are projected to be about 10 L in 2024.
The webinar, hosted by NAPi on June 4, 2021, included other key public health organisations like Breastfeeding Promotion Network of India (BPNI), Paediatric and Adolescent Nutrition Society (PAN), and Epidemiology Foundation of India (EFI), that spoke of the Future of a ‘Strong Nutrition Profile Model (NPM)’ to guide consumption of processed and ultra-processed food in India towards eradicating the NCD burden. Leading global experts, doctors and senior scientists discussed the need for a consensus particularly in light of obstacles such as opposition from the food industry.
In 2018 the Food Safety Standards Authority India (FSSAI) published a draft regulation for FOPL which was subsequently withdrawn for further deliberation. In 2019 December, FSSAI delinked FOPL from general labelling regulations and is currently seeking consultations with civil society, industry and nutrition experts for a viable model for India. Extensive research regarding the appropriate ‘cut offs’ for nutrients of concern has already taken place, including a recent study by the National Institute of Nutrition which corroborates the limits on salt, sugar and fats set by WHO.
