Centre for Science and Environment (CSE) researchers point out that as per 2017 statistics provided by the Indian Council of Medical Research (ICMR), the share of deaths in India due to non-communicable diseases (NCDs) jumped up from 38% in 1990 to 62% in 2016. According to the National Family Health Survey (NFHS) 5, almost 17% of India’s adult male population and over 14% of adult female population is diabetic – this proportion was 8% and 6% in NFHS 4.
A 2020 ICMR-NCDIR (National Centre for Disease Informatics and Research) report says over 28% of Indians suffer from high blood pressure. Over 42% of the urban population and 18% of the rural population is overweight.
NFHS 5 points to another disconcerting truth: there has been increase in obesity in women in 16 of the 22 states surveyed; the number for men is 19 states. Also, in 20 of the 22 states, increasing numbers of children are becoming overweight.
“It was seven years ago – in 2013 – that an expert committee set up by the Food Safety and Standards Authority of India (FSSAI) first recommended a series of steps to regulate junk food and inform consumers about ingredients through simple and effective labelling, like front-of-the-pack. We were part of that exercise. Ever since, it has only been a tale of more committees, delays and dilutions, while India continues to sit on a ticking time-bomb of non-communicable diseases,” said CSE director general Sunita Narain addressing a global webinar on ‘Front-of-Pack Labelling on Packaged Foods’.
Amit Khurana, programme director, food safety and toxins unit, CSE said “We are experiencing a dietary shift in India: consumption of processed and ultra-processed packaged food is going up. Ultra processed foods – junk foods – are more like a factory product than a food. They are high in salt, sugar, refined carbohydrates, chemicals and empty calories. They are aggressively promoted, and widely and easily available. It is critical to have front-of-pack (FoP) labelling (besides the back of pack label which provides the nutritional information) for such products.”
Narain said that consumers must get to know which food is bad, and how much of it is bad. The primary purpose of a FoP label is to provide the consumer this information. FoP labels are consumer friendly. They are easily noticeable at the front, can be understood better, and can encourage healthy eating habits, Khurana added.
The webinar, organised by CSE, had among its speakers Barry Popkin, professor of nutrition at the Gillings School of Global Public Health, University of North Carolina, USA; Mary L’Abbe, professor, Department of Nutrition Sciences, University of Toronto, Canada; Lakshman Gamlath, former deputy director general, Environmental Health, Occupational Health & Food Safety, Sri Lanka; Rachita Gupta, national professional officer (nutrition), World Health Organization; Rekha Harish, paediatrician and former vice president, North Zone Indian Academy of Paediatrics; Ashim Sanyal, chief operating officer, Consumer Voice; George Cheriyan, director, Consumer Unity and Trust Society (CUTS); and Vandana Shah, regional director, South Asia program, Global Health Advocacy Incubator.
Warning FoP labels on ultra-processed foods have proven to be most effective in other parts of the world; experts at the webinar recounted experiences from Chile and Sri Lanka. Speaking at the event, Dr Popkin said: “Many studies have been conducted to show how front-of-pack labels are effective, but it’s only the mandatory warning labels that have brought change in the real world.”
“In Canada, with these labels on foods, people can choose what to buy in less than eight seconds,” said Mary L’Abbe, who has been closely involved in Canada’s movement towards mandatory warning labelling.
CSE researchers say that in India, the nutrients to be displayed on the FoP label should be ‘total fat’, ‘total sugar’ and ‘salt’ (against ‘saturated fat’, ‘added sugar’ and ‘sodium’). Khurana said that these were proposed by the FSSAI in its 2018 draft, but later diluted due to pressure from the industry. The FoP label should inform the consumer, while the back-of-pack label should be meant for scientific understanding and compliance. Both should complement each other. Putting ‘sodium’ on FoP will not help the consumer.
FSSAI’s proposed 2018 and 2019 FoP labelling is based on thresholds decided on by the WHO-South East Asia Region (SEARO) nutritional profiling. This model has been pilot-tested in India as well in 2016 on over 1,100 products. The thresholds have considered the applicability, palatability, and preservation of these foods, informed Rachita Gupta (WHO) at the webinar. Rekha Harish opined that no relaxation should be given on these thresholds.
Narain urged the government to bring in the FoP regulation: Narain said, “It’s time we moved ahead and introduced simple and interpretive warning labels on our foods. The global understanding has evolved – four years back we thought the traffic light system was the most effective FoP system, but now we clearly see that warning labels are really working.”
She added: “Companies should not be selectively allowed to implement it – it should be mandatory and be consistently applied on all products. There is no question about the suitability of WHO-SEARO nutrition profiling thresholds in the Indian context. If any changes are to be made, they should only be further tightened, not relaxed.”
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