India needs to face up to its junk food crisis

By Mihir Sharma

India is not the world’s healthiest country. Sadly, regulators seem determined to make the problem worse with each passing year.

Urban Indians, especially wealthier ones, have a relatively sedentary lifestyle, and our diet is heavy in carbohydrates and fats. This may not show up easily in the numbers, given the size of the country’s population. Analysis in the Lancet recently found that about 23 per cent of Indians were technically overweight, defined as a body mass index over 25. Many parts of the world, such as West Asia and Eastern Europe, do much worse.

But, when you break the data down, worrying trends emerge. Women over 30, for instance, have startlingly high rates of abdominal obesity in India — with a prevalence of over 55 per cent for women older than 40. That is a more dangerous indicator of predisposition to metabolic disease than regular BMI.

Moreover, genetics seem to make Indians particularly vulnerable to such ailments. One scientist at the generic pharma major Lupin Ltd. has pointed out that Indians tend to have greater insulin resistance and develop Type II diabetes at a younger age than the average. The Lancet suggests that over 100 million Indians have diabetes, and 136 million are pre-diabetic. That’s a crisis — one that’s set to grow worse as India becomes richer and more urban.

The problem is usually blamed on a change in the diets of middle-class Indians, from fresh to processed foods. The assumption is that packaged products are unhealthier. It’s right there in the name: “junk food.”

I’m a tiny bit skeptical. I am addicted to Delhi’s deep-fried street food, and I am not so sure it is better for me than anything I could buy in a supermarket.

At the same time, there is data suggesting junk food in India is worse than in many other countries, with higher levels of salt, sugar, and saturated fats. More importantly, packaged food can be regulated, so people at least know what they’re eating. Ideally, that would allow consumers to better manage their intake of fat and salt.

There remains a lot of room for this transition in India. Nestle India Ltd. claims that branded food makes up only a third of the Indian market but will expand at a compound annual growth rate above 12 per cent in coming years.

The question is whether regulators are up to the task. They recently announced that nutritional information about sugar, salt and saturated fat would henceforth be displayed “in bold letters and relatively increased font size on labels of packaged food items.” The news was generally welcomed.

In fact, it represented a significant climbdown. The new rules specify that this information will be estimated based on (arbitrary) serving sizes, and as a percentage of recommended daily intake. Translating this into “good” or “bad” requires a level of mental math that the average shopper likely won’t want to endure.

The regulations replace a draft plan that would have imposed fewer requirements on shoppers but was still flawed. In 2022, officials proposed a “star” rating, similar to the ones used to indicate if an appliance is energy-efficient. As scientists pointed out, that merely “helps the consumer choose the least unhealthy option among a host of unhealthy options.”

Critics worry that India’s food regulators respond more readily to big food companies than to doctors. The last time they backtracked on warning labels, they placated angry consumers by telling them a new adviser would study the issue — a man whom the New York Times described as leading an institution “almost entirely funded by the Goliaths of the agribusiness, food, and pharmaceutical industries.”

The processed food industry is shooting itself in the foot. If companies want Indians to make the switch from mouth-watering street food, they ought to welcome greater transparency, so consumers can be certain they are choosing healthier alternatives.

Better models are available even in India’s neighborhood. In Sri Lanka, for example, sodas are labeled with a “traffic light” system that goes from green (healthy) to red (godawful levels of sugar). Recent research has shown that the system consistently steers consumers towards healthier choices.

Indians need simple, easy-to-understand, and prominent warning labels, so that their better natures are given a chance to overtake their impulses. Otherwise, their richer country will only be an unhealthier one.