Unhealthy ultra-processed food perpetuates all forms of malnutrition and non-communicable diseases.

Healthy diets, diverse foods during pregnancy, at birth, infancy and early childhood can tackle both under and over nutrition, offset epidemics of non-communicable diseases. If the recommendations of a recent KPMG report to Karnataka State Rural Livelihood Promotion Society are acted upon, India’s children will end up consuming low cost, fortified, unhealthy processed foods as flavoured sweet or sour powders or biscuits. Targeting families with Rs 1,000-60,000 monthly income, with intense above the line (ATL) and below the line (BTL) marketing, these families will want to buy and consume these unhealthy foods. The KPMG report claims to deal with India’s malnutrition, stating lack of availability of such foods has direct correlation with under nutrition. “No Low-cost Fortified Energy Food presently available in the market, there is no defined route to market.” The report proposes multiple manufacturing units to tap the market. States are already grabbing such ideas as “Tata Trusts” and “Mars Foods” have already partnered to sell high protein crunchy snacks, again unhealthy ultra-processed foods for children called “GoMo Dal Crunchies”.

According to global experts, malnutrition and unhealthy diets are important risk factors for NCDs that claim 71% of global deaths (41 million) each year. Every year, roughly 5.8 million Indians die from heart and lung diseases, stroke, cancer and diabetes.

Malnutrition, for the benefit of readers, includes both under-nutrition and over nutrition, both are caused by unhealthy, poor quality diets, and are linked to NCDs. Only one out of ten of India’s children (6-23-month age group) eats a diverse minimum acceptable diet e.g. fruits/vegetables, and two out of five children receive healthy diet during the first six months in the form of exclusive breastfeeding. India’s over 35 million of underweight children under five years of age and rapidly rising obesity among middle and higher-income groups are both a problem India has to tackle urgently.

According to India’s National Family and Health Survey (NFHS 4), in the past 10 years, the number of obese people has doubled in India. India has the second highest number of obese children in the world, with 14.4 million reported cases, according to a recent study published in The New England Journal of Medicine. Epidemiologic studies indicate that overweight and obesity are important risk factors for Type 2 diabetes (T2DM), cardiovascular disease (CVD), cancer and premature death.

Food systems are to respond to this problem.

India has the dubious distinction of having the maximum number of undernourished children both at birth and first two years of age. India, with its rapidly growing market economy, is the target of the food companies to boost the sales of processed foods; without any concern for the long-term health of consumers. Corporations use aggressive marketing as a key strategy for selling unhealthy foods, including selling on discounts, use of health claims etc., and are legitimised by academics, celebrities and organisations with interest. Such marketing undermines healthy eating and displaces real foods and is linked to obesity.

India’s plan of action to deal with NCDs calls upon ministries to work with the private sector. The private food sector, because of its vested profit interest, gets on to the policymaking table. The food system prioritises on promotional campaigns and individual choices rather than delivering healthy, un-processed foods.

Such a food system has to be fixed with radical reforms including both what and how food is produced, marketed and consumed.

We hear TV commercials on a daily basis by a biscuit brand claiming “Healthy India banayenge” (making India healthy). Other brands push sugary beverages or health/energy drinks without even letting people know the amount of sugar they gulp in a single helping and mostly in association with celebrities. Unless the food system fixes and regulates to end such marketing it will be futile to expect healthy eating. Other reforms, which are required, include disincentives to produce unhealthy foods and incentive for healthy foods, taxing unhealthy foods, mandatory labels on unhealthy foods easily understood by the public, better/healthy standards for foods in schools, hospitals and institutions, enforcing the existing Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, and Amendment Act 2003 and ending all inappropriate promotion of foods for infants and young children.

Many steps are under way but more needs to be done.

The KPMG report is proposing to produce ultra-processed foods and market these intensively using celebrities. Those who argue entry of the private food sector, don’t want to talk of aggressive promotion tactics, including surrogate marketing and the harm it may cause, because it is linked to the bottom line. As people buy and consume foods under the influence of intense marketing, it cannot be said to be an “individual’s choice”. Policymakers are to understand that marketing of unhealthy foods (with high sugar or salt, and or highly processed foods) increases their consumption and is therefore harmful.

Authors of a new report in the Lancet concluded: “Dietary policies focusing on promoting healthy eating can have a more beneficial effect than policies advocating against unhealthy foods.” This is exonerating the food industry, obviously helpful to the industry, quite a strategic move. This report of the EAT Foundation and Lancet is backed by several food industry giants or their associations and supported by the SUN (scaling up nutrition) movement, which distorted the definition of conflicts of interest to accommodate private sector and has a business network. The Global Alliance for Improved Nutrition (GAIN), who had been claiming to benefit 600 companies, is a partner with FSSAI in the India launch.

Point is made to the policymakers for radically reforming the food system. Availability of real and healthy foods including safe drinking water is one of the answers and wiping off unhealthy foods from the plate.

Governments and FSSAI may disband existing partnerships with private food sector that supplies/provides unhealthy foods. Otherwise, you will be seen as a partner in crime; making choices that are detrimental to health.

More can be done by banning all celebrity endorsements of unhealthy foods, the double bonanzas or discounted foods as part of the radical reforms.

In the end, two questions. Will the political parties make healthy policy choices while aspiring to be on the driver’s seat for governance? Will a Parliamentary committee interrogate FSSAI and the private food sector on this matter? You have the power to shift the direction, otherwise, what Irwin Corey said, “if we don’t change the direction soon, we’ll end up where we’re going”, will be the unfortunate future for India.

Dr Arun Gupta, MD FIAP, is Central Coordinator, BPNI; MD, World Breastfeeding Trends Initiative; Regional Coordinator, IBFAN South Asia; Convener, Alliance Against Conflict of Interest and Nutrition Advocacy in Public Interest.

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