The poor diet of people today is responsible for more deaths worldwide than any other risk factor. This has also led to obesity, type 2 diabetes and cardiovascular disease. Global estimates suggest that almost 2.3 billion children and adults are overweight. The growing availability of ultra-processed foods, which contain high levels of sugars, sodium, saturated fats and refined carbohydrates, is a key contributor to the current obesity epidemic.
India is an interesting example where undernutrition and obesity coexist as a classic case of the double burden of malnutrition. Both undernutrition and over-nutrition are the two faces of the same coin i.e. malnutrition. India is home to around 15 million obese children. This is the second-largest number after China.
On average, 15 % of Indian children are facing some form of obesity. On the other hand, more than 45 million children in India are stunted or under-growth, which is a third of the world’s total stunted children. Nearly half of all under-five child mortality in India is attributable to undernutrition.
A study conducted by the Lancet Commission on the comparison of the Indian diet found out that ultra-processed packaged food accounts for nearly 10% of the average total caloric intake in both rural and urban India. Urban households in high economic affluence consume almost 30% of their total daily calories from processed food.
Further, the Center of Science and Environment (CSE), a well-known civil society voice in India, in its survey ‘Know your Diet’ found the high burden of packaged food on school children. The survey indicates that more than 50% of children consumed ultra-processed package food at least twice a week. This food is laced with high salt, sugar and fat, such as chips, instant noodles, chocolates, ice-creams and sweetened carbonated beverages.
The adverse health effect of unregulated ultra-processed food and drinks in under-nutrition or stunted children, who received inadequate nutrition early in their lives, are more pronounced compared to such children who received adequate nutrition due to their weak immune system. Stunted children, later in the life, if consume regularly unregulated ultra-processed food and drinks laced with high fat, salt and sugar, as a replacement of common nutritious cook food, are more susceptible to obesity and may face one or other forms of non-communicable cardio-vascular diseases like hypertension, diabetes and heart ailments later in their lives.
There is a general perception that the prevalence of high consumption of ultra-processed food and drinks is largely among the rich, urban and affluent classes. It is true to some extent, but the scope of consumption of ultra-processed food and drinks among economically poor, rural and underprivileged sections of society is growing rapidly.
There are four factors that are contributing high prevalence of unregulated ultra-processed food and drinks consumption in economically poor, rural and underprivileged sections of society where a maximum number of stunted or undernourished children belongs to. These are:
1) Increasing urbanisation or urban functions in smaller towns and rural areas,
2) Rising income among all strata of the society,
3) Less time for food preparation due to the high work-stress environment, and
4) lucrative marketing strategies of the food and beverage industry.
These four factors contribute significantly to the food transition in which affordable, convenient and hyper-palatable ultra-processed food and drinks that are ready to eat or ready to heat take a major share of the daily diet of the larger population in the country including economically weaker sections and migrant workforce.
In a nutshell, unhealthy diet choices, often dominated by unregulated ultra-processed foods and drinks, coupled with the fast-paced urban lifestyle, are the main risk factors for growing NCDs and the accelerated double burden of malnutrition among Indian children.
Front-of-Packet Labelling (FOPL) is one such policy instrument that facilitates and empowers consumers to make healthier choices while purchasing packaged food products from the store. Often, a consumer takes less than 10 seconds to select package food products from the store — not giving them enough time to read and interpret the complicated nutrition facts panels.
Given this background, the People’s Vigilance Committee on Human Rights (PVCHR), PIPAL (People’s Initiative for Participatory Action on food Labelling), and The CommonMan Trust are organising a public dialogue where senior representatives of major political parties in conversation with global and Indian health and nutrition experts will share their thoughts and opinion on securing nutrition rights of Indian children through the front of packet labelling regulation and thereby save our children from adverse effects of the double burden of malnutrition.
The public dialogue will be held on December 2, 2021, at Hotel Diamond, Bhelupur, Varanasi. This is the third such initiative organised by this collective of FOPL.
About the author: Ashish Singh is a sociologist and political scientist.