By Souparno Banerjee*
This year’s World Health Day on Diabetes is most significant for a country like India. Observed on April 7 by the World Health Organization, Beat Diabetes – this year’s theme — is immensely relevant to India, which is home to over 60 million people suffering from diabetes; the number is expected to rise steeply in the years to come.
Most prevalent form of diabetes is Type 2, which is a diet-related non-communicable disease (NCD) along with hypertension, heart disease and certain cancers. Excess consumption of unhealthy junk foods specifically among children is strongly linked with growing prevalence of obesity and NCDs. These foods are ultra-processed and are high in salt, sugar, fats. They lack fibre, vitamins and minerals and contain chemical additives. Such foods include carbonated soft drinks, chocolates and other confectionary, ice-creams, instant noodles, pizaa and burger from fast food outlets.
“India needs to take measures to limit consumption of junk food. It should be integral to government’s plan to contain diet-related NCDs. A set of comprehensive measures are required. It should regulate marketing of foods, drastically improve-upon existing labelling norms, limit availability of junk foods in schools and run public awareness campaigns”, says Chandra Bhushan, deputy director general at Centre for Science and Environment (CSE).
India is witnessing change in lifestyle and transition in dietary habits from traditional, fresh foods to modern packaged foods. Obesity is near epidemic now and is a severe problem with children. Diabetes is prevalent like never before and Indians are being affected by it at a much younger age than people in other parts of the world. The problem has extended to rural areas too.
“The food industry should not be allowed to aggressively target our children. No celebrity should be allowed to advertise soft drinks, chocolates, noodles etc. Broadcast of food advertisements should be prohibited on programmes that are watched by children. No such company should be allowed to sponsor events at schools. No junk food should available at schools or near-by. Mandatory government controls are required as successfully done in other parts of the world,” adds Chandra Bhushan.
“The food authority needs to reform labelling provisions. Salt is yet not required to be mandatorily labelled on packaged foods. There are no provisions to inform consumer about how much a particular food or portion of it contributes to the recommended daily intake of salt, sugar or fat. Serving sizes are not standardized. These are best practices across the world”, says Amit Khurana, programme manager, food safety and toxins, CSE.
“In fact, the need of the hour is warning labels that clearly highlight that a particular food is unhealthy due to presence of high salt, sugar or fat. Just the way it’s been talked about in case of tobacco,” adds Khurana.
Other global best practices on labelling of packaged foods are easy to understand front-of-pack labelling, and a stated criteria for nutrient and health claims such as low in added sugar, low in salt, high in dietary fibre etc. Menu-labelling and labelling at point-of-purchase of calories, salt, sugar and fats would also be useful in a country like India.
Reduce other environmental risk factors like air pollution that can exacerbate diabetes
Growing air pollution is now being strongly associated with metabolic and lifestyle diseases like diabetes. Large-scale population-based studies have linked diabetes with air pollution. Studies have found strong and consistent association between diabetes prevalence and PM2.5 concentrations. For every 10 μg/m3 increase in PM2.5 exposure, there can be increase in diabetes prevalence. A large scale study published in Diabetes Care 2011 has found that counties with higher levels of PM2.5 had a more than 20 per cent increase in diabetes.
This remained even after controlling for other diabetes risk factors. Even lab tests show increase in insulin resistance and an increase in markers of inflammation that contributes to insulin resistance, after particulate exposure. As a matter of public policy an integrated approach that combines good food strategy with control of environmental risk factors to reduce the disease burden and health costs associated with diabetes.
*Centre for Science and Environment, Delhi. Contact: firstname.lastname@example.org