Explainer: Why study on risks of ultra-processed foods demands urgent action

A three-part study published in The Lancet last week has thrown up some alarming facts concerning the Indian populace. In the past two decades, Indians have changed their traditional dietary habits and are eating more ultra-processed foods (UPFs). Since 2006, the spending on UPFs has increased by about 40 per cent from about Rs 7,966 crore in 2006 to nearly Rs 3.3 lakh crore in 2019.

Why the findings matter

In the corresponding period, obesity rates have doubled. Approximately one in four Indian adults is obese, one in 10 has diabetes and one in three has abdominal obesity. According to the National Family Health Survey-5 (2019-2021), around 24 per cent of women and 23 per cent of men are obese. There has been a rise in childhood obesity as well.

The percentage of overweight/obese children under five has increased from 2.1 per cent in NFHS-4 (2015-16) to 3.4 per cent in NFHS-5 (2019-21). Obesity and associated chronic non-communicable diseases are already costing the country an estimated Rs 2,890 crore every year.

The findings of the series, authored by 43 international experts, have triggered a national debate. “These findings are a cause of concern for everyone because the next generations are being affected,” says Dr Rakesh Kochhar, former president of the Indian Society of Gastroenterology.

In the past 40 years, about 50 per cent of the daily diet in the West has been replaced by UPFs. In India, this figure was around 30 per cent. But recent data shows that we are catching up fast. It was earlier believed that this dietary shift was only in the urban areas, but it has percolated down to the rural areas as well — an alarming development.

“From early age, toddlers are fed ultra-processed foods. By the time they reach their teens or twenties, they start feeling the ill-effects of obesity and associated diseases. Just in the last three months in my practice, I have seen at least four to five students of classes X and XII who had ulcerative colitis (chronic inflammatory bowel disease that causes inflammation and ulcers in the large intestine and rectum). Earlier, we used to see these cases not before the age of 35 or 40. And the treatment is lifelong. We are also seeing rising cases of fatty liver in people in their 20s. Fatty liver can cause cirrhosis of liver and liver cancer. Earlier, we used to see such incidences in people in their 40s,” says Dr Kochhar, also a former Professor of Gastroenterology at PGI, Chandigarh.

Dr Arun Gupta, one of the authors of this three-part series, says these findings are going to have a far-reaching impact because people are not realising that these hyper-palatable UPFs have no nutritional value, are full of high fat, sugar, or salt (HFFS), toxic chemicals, additives and, above all, these are quite addictive.

A 2013 study on lab rats by researchers from Connecticut College, US, found that eating Oreo biscuits could activate the brain’s ‘pleasure centre’ with a strength comparable to or greater than that of cocaine or morphine. These findings suggested that both HFFS foods and drugs of abuse trigger brain’s addictive processes to the same degree, and compared these maladaptive eating behaviours, which are contributing to rising obesity levels, to drug addiction.

The way forward

Aggressive marketing and advertising constantly targeting children and youth definitely impact consumer choices and behaviour. Awareness campaigns to check or modify this behaviour are a long-term solution. An immediate and urgent need is to restrict the ease of access to these addictive UPFs as well as ensure the easy availability of reasonably priced fresh, wholesome food that doesn’t come wrapped in colourful packages.

“If the government wants to check the rising obesity and diabetes cases in India, an immediate and serious policy action is required. The Lancet study has already suggested a few strong regulatory measures on the advertising, availability, front-of-pack warning labels on HFSS foods,” adds Dr Gupta. These include a ban on advertisements of UPFs targeting children or at least banning such advertisements between 9 am and 10 pm, a ban on the sale of UPFs in public spaces, especially school and college canteens, as well as the easy availability of healthy food in these places and high taxation on ultra-processed foods.

“Till a policy is in place, we as parents and consumer welfare activists must ensure that these foods are out of reach of the children,” says Ashim Sanyal, CEO, Consumer VOICE, an international advocacy group working in the field of consumer awareness and education.

The Food Safety and Standards Authority of India (FSSAI) already has a regulation that bans the sale and marketing of HFSS foods in school canteens and within a 50-metre radius of these institutions, he points out. “Its strict implementation can help. But, ultimately, it remains a policy decision and that will only happen when there is reverse pressure from consumers. A multi-pronged strategy that includes advocacy, awareness, and media outreach is needed if we want to safeguard our children from addiction to ultra-processed foods and corporate greed,” adds Sanyal.