In India, the burden of obesity and diet-related non-communicable diseases (NCDs) such as diabetes, hypertension, and heart disease continues to rapidly grow across all parts of the country. In 2016, India reported 63 per cent of total deaths due to NCDs, of which 27 per cent were attributed to cardio-vascular diseases (CVDs). CVDs also account for 45 per cent of deaths in the 40-69 year age group. Similarly, studies reveal that 77 million people are diabetic in India, the second most affected in the world, next to China. This means that one in six people in the world, with diabetes, are from India. According to a recent report released by the Ministry of Health and Family Welfare, around 26 per cent of Indians above 45 years, were hypertensive and one in every three senior citizens were diagnosed with hypertension.
Prevalence of obesity is a cause of great concern as its adverse consequences include ischemic heart disease, diabetes, and infertility. Studies show that more than 135 million people are obese in India and a big worry is that children and adolescents are getting impacted by it.
This clearly indicates that we have a crisis on hand! One of the major factors for the above mentioned NCDs epidemic is the transition happening with our diets. We are increasingly consuming processed/packed food, which are often high on nutrients of concern such as salt, sugar and/or fat. Recognising the seriousness of the matter, the Food Safety and Standards Authority of India (FSSAI) issued the Labelling Regulations, where it was made mandatory for the industry to provide complete nutritional information on the food packs so that consumers can make informed choices. However, over the years, it has been noted that this information, usually provided at the back of the pack, does not adequately inform consumers. The barriers include illiteracy, language, the time spent by a consumer in reading a label, confusing information, and difficulties in understanding the details.
In these circumstances, what is most needed is two-fold: 1. scientific thresholds for the presence of the nutrients of concern like salt, sugar and fat in various food products 2. If these nutrients are present in values beyond the prescribed limits, clear warnings to consumers on the front of the pack, which will help them make informed choices.
As part of their national strategies to contain NCDs, several countries have already moved towards labelling on the front of pack – as either voluntary or mandatory requirement. Several designs like nutriscore, traffic signal, health star rating, warning labels, have been adopted which vary in their effectiveness. Of these, “warning” labels are proving to be popular and successful in nudging consumers towards making informed decisions. Countries like Chile and Israel use these warning labels and studies reveal that Chile showed a reduction in purchase of food products high in sugar, salt and fat, after introduction of the mandatory warning front of pack labeling system.
Similarly, for a country like India, an easy to comprehend interpretative label design, which will clearly warn the consumers on the presence of high salt, sugar, fat content in food, will be ideal as it will cut across the barriers of illiteracy, language, etc. We already have the experience of using such symbol/image based labels on tobacco products and vegetarian and non-vegetarian food, which are successful in helping create awareness and making informed choices.
It is good that the FSSAI is working towards issuing the front of pack labelling regulations soon. Though discussions have been going on for many years now, the consultations gathered momentum over the last few months. With the steep increase in NCDs, what we direly need are labels that are simple and easy to understand and serve the true purpose of “warning” consumers about the unhealthy levels of nutrients of salt, sugar and/or fat present in processed/ultra- processed food so that they are able to make informed decisions.