Regulatory push, multi stakeholder engagement required to address growing obesity rates

Mumbai, January 5, 2023:

With growing obesity rates and under-nutrition in adolescent population in India a concern, regulating their food environment and promoting nutrition literacy for healthy and informed food choices is urgently required, according to the Public Health Foundation of India (PHFI).

India has a fifth of the world's adolescent population along with the co-existing problem of under-nutrition in India. Over 17 million children, aged 5 years to 19 years in India are affected by obesity. If left unchecked, these numbers will increase to 27 million by 2030.

The PHFI is knowledge and implementation partner along with Indian Council of Medical research (ICMR)-National Institute of Nutrition (NIN), United Nations Children Emergency Fund (UNICEF) and other consortium partners including, the Institute of Economic Growth (IEG), the World Health Organisation (WHO), Deakin University, and the World Obesity Federation (WOF) to address this on priority basis.

“In India, Food Safety and Standards Authority of India (FSSAI) is considering India Nutritional Rating (which is akin to star rating) for front of pack nutrition labels (FOPNL). The regulation was drafted recently and public feedback was invited. Based on the same, we hope appropriate FOPNL format will soon be decided for India and introduced,” informed Dr Subba Rao M Gavaravarapu, Scientist 'F' & Head Nutrition Information, Communication & Health Education (NICHE), ICMR-NIN. 

The nutrition information provided on the food labels is very important and consumers should make it a habit to read food labels to choose healthy.

In addition to FOPNL, some countries like Mexico have demonstrated that fiscal measures and taxing of unhealthy foods can be helpful in controlling the consumption of HFSS foods. WHO has brought out guidelines on restricting advertising and marketing of unhealthy foods to children and adolescents. Industry voluntary bodies like the Advertising Standards Council of India (ASCI) have also brought out guidelines to restrict misleading claims and advertisements.

“They should also come forward to restrict marketing and advertising of unhealthy foods to children and adolescents. While all these measures, if introduced together, have the potential to modify the obesogenic food environments, nutrition literacy is the most important ingredient in ensuring the success,” Dr Subba Rao M Gavaravarapu emphasized.

The PHFI recently conducted a content analysis of food advertisements on popular television channels among children and youth in India. The results revealed that a total of 88.6% of 1735 food advertisements were for HFSS foods and a higher proportion of food advertisements were seen on children’s channels (38%) than on youth channels (23%) (P<0.001).

The study highlighted that the majority (90%-95%) of advertisements broadcasted on television channels targeting children and youth were of food high in fat, salt and sugar (HFSS) foods. These studies laid the foundation for designing and initiating the “Let’s Fix Our Food” (LFOF) campaign to combat an obesogenic environment for children and youth.

The ICMR-National Institute of Nutrition, The Public Health Foundation of India (PHFI) with support from UNICEF-India, along with several likeminded government and multilateral organisations have been spearheading an initiative called ‘Let’s Fix Our Food’ with an aim to bring the views and lived experiences of adolescents and children to the centre table of discussions about food environment.

The LFOF initiative, aims to create a space for adolescents to participate and create a conducive healthy food environment in the country and will lead to ownership of issues as campaigns are designed and delivered by the youth.  It also has a potential to create health-promoting norms among adolescents and support policies to address both ends of malnutrition: obesity and undernutrition.

Findings of a recent study conducted by the PHFI’s research team with support from the WHO country office for India in 2021 highlighted that the advertising environment in and around schools is obesogenic, despite government and educational institutes guidelines on restricting the availability and accessibility of HFSS foods.

At the same time, front of pack nutrition labels (FOPNL) are being advocated as one of the easiest ways to inform the people about the healthiness of the food. FOPNL formats can be broadly divided into summary labels and warning labels.
Summary labels take into consideration both the positive nutrients (like protein, vitamins, minerals etc) and nutrients of concern (fat, sugar, salt and total calories), whereas warning labels only inform the patients about the nutrients of concern upfront on the pack with a symbol.

Examples of summary labels can be like the Health Star Rating used in Australia and New Zealand or the NutriScore rating used in European countries, whereas countries like Chile have demonstrated the usefulness of Warning Labels to reduce the consumption of HFSS foods.

“While taste, convenience, brand loyalty, peer pressure and aspirational value could be the other determinants of food choices, the processed food is so aggressively marketed and advertised that they address all these nudges and their appeal becomes irresistible,” Dr Subba Rao M Gavaravarapu concluded. Pharmabiz