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• In June 2023, a study conducted by the Madras Diabetes Research Foundation in collaboration with the ICMR and the Union Health Ministry revealed alarming statistics about India’s diabetes crisis.

Central idea

• According to the study, 11.4% of India’s population, approximately 10.13 crore people, are living with diabetes. According to the WHO, a major reason for this is the consumption of unhealthy, ultra-processed foods and beverages. These statistics demand immediate attention and concrete actions to address the root causes of this public health crisis.

Key findings of the study

• Living with diabetes: 4% of India’s population, or 10.13 crore people, are living with diabetes.
• Pre-diabetic: 3% of the population, or an additional 13.6 crore people, are pre-diabetic.
• Obese Population: 6% of the population would be considered obese as per the BMI measure.

The consumption of ultra-processed foods: a significant contributor

• Contents of Ultra-Processed Foods:

• Ultra-processed foods encompass a wide range of products, including carbonated drinks, instant cereals, chips, fruit-flavored drinks, instant noodles, cookies, ice cream, bakery items, energy bars, sweetened yogurts, pizzas, processed meat products, and powdered infant formulas.
• These items are often characterized by their convenience and long shelf life.

• Increased Risk of Diabetes with Scientific Evidence:

• A concerning statistic reveals that a mere 10% increase in daily consumption of ultra-processed food is associated with a 15% higher risk of type-2 diabetes among adults.
• These foods are often high in sugar, fat, and salt, all of which contribute to insulin resistance and elevated blood sugar levels.

• Impact on Weight Gain:

• Ultra-processed foods are engineered to be hyper-palatable. They often contain combinations of sugars, fats, and artificial additives that stimulate the appetite and lead to overconsumption.
• This excessive calorie intake can result in weight gain, a known risk factor for type 2 diabetes.

• Structural Alteration:

• When food undergoes extensive processing, its original structure is often destroyed. Cosmetic additives, colors, and flavors are added to enhance taste and appeal.
• This altered structure and excessive processing can disrupt the body’s natural regulation of hunger and satiety, leading individuals to eat more and gain weight.

• Association with Cardiovascular Risks:

• The negative effects of ultra-processed foods extend beyond diabetes. Obesity and diabetes are key risk factors for heart disease and premature mortality.
• Research indicates that those who consume more than four servings of ultra-processed foods per day face a significantly higher risk of cardiovascular mortality compared to those who consume fewer than two servings per day.
• A similar trend is observed for all-cause mortality.

Exploitative marketing practices

• Shifting Focus to Low- and Middle-Income Countries:

• In many high-income countries, the sale of sugar-sweetened beverages has declined over the past two decades due to growing awareness of their health impacts.
• To compensate for this loss of sales, food companies have shifted their attention to low- and middle-income countries, where there may be less stringent regulations and a growing consumer base.

• Aggressive Marketing and Advertising:

• These companies invest substantial amounts of money in marketing and advertising ultra-processed food and beverages in countries like India.
• These aggressive marketing campaigns often target vulnerable populations, including children and the emerging middle class.
• Techniques like the use of cartoon characters, incentives, gifts, and celebrity endorsements are employed to make these products more appealing.

• Blaming Individuals vs. Addressing Systemic Issues:

• The food industry tends to place blame on individuals, suggesting that personal choices are responsible for unhealthy dietary habits.
• However, the environment created by aggressive marketing and the easy accessibility of ultra-processed foods play a significant role in shaping these choices.

• Impact on Public Health:

• The consequences of these marketing strategies are severe. They contribute to a deepening public health crisis, with diabetes being a ticking time bomb.
• Sugar-sweetened beverages, in particular, are highlighted as a major source of added sugar in diets, putting people at a higher risk of type 2 diabetes and other health issues.

The need for regulatory intervention

• Industry Opposition: The food industry resists marketing restrictions, citing economic concerns and portraying themselves as stakeholders.
• False Promises: Some industry initiatives, like ‘Eat Right,’ may appear health-focused but could divert attention from unhealthy product impacts.
• Impact on Regulation: Industry partnerships can hinder strong regulatory policies aimed at reducing ultra-processed food consumption.
• Role of Regulatory Authorities: Lackluster responses and industry dominance in regulatory bodies may impede effective public health regulations.
• Complementary Efforts: While exercise is essential, it should complement regulatory policies addressing marketing and warning labels on unhealthy foods.
• Balancing Interests: Governments must prioritize citizens’ health, striking a balance between industry interests and public well-being when implementing evidence-based, transparent regulations.

Strategy to safeguard: Mandatory Provisions

• To protect the public from the manipulative strategies of the food industry, the government must establish a legal framework or even an ordinance under Article 123 of the Constitution.
• This framework should focus on reducing or halting the consumption of ultra-processed foods and could include:

1. Defining ‘healthy food’
2. Implementing warning labels on unhealthy food
3. Imposing restrictions on the promotion and marketing tactics of unhealthy food and beverages
4. Raising public awareness about the risks associated with consuming such foods

Global Examples

• Several countries, including South Africa, Norway, and Mexico, have recently taken similar actions to regulate food labeling and marketing.
• The Indian government has the opportunity to demonstrate its commitment to public health by enacting similar laws.
• Much like the Infant Milk Substitutes, Feeding Bottles, and Infant Foods Act, which successfully regulated commercial baby food, this proposed legislation could make significant strides in curbing the consumption of unhealthy foods and beverages.

Conclusion

• India stands at a critical juncture in its battle against diabetes and a food industry that prioritizes profits over public health. The time has come for the government to implement robust regulations. By taking decisive action, India can protect the well-being of its citizens and set a precedent for responsible food regulation in the global context.

Also read:

Is India a Diabetes capital of the world?