One of the first declarations of the newly elected government in June was a proposal to ban unhealthy or junk food (defined as food high on fat, sugar and salt) in school canteens across the country. This was followed up with an increase in the prices of soft drinks in the recent budget.

Discouraging availability

This has been part of a long-standing demand of activists, nutritionists and public health experts to discourage the availability of and other food items containing unhealthy ingredients. This includes a Public Interest Litigation (PIL) plea in the Delhi High Court demanding a ban on junk food and carbonated drinks in schools and on their sale within a radius of 500 yards.

There is no disagreement among health and nutrition experts that the ‘developed’ world is in the grip of an obesity epidemic and ‘developing’ countries like India are fast following suit. The World Health Organisation (WHO) warns that more than 40 million children under the age of five were overweight or obese in 2012. If left unchecked, this figure would rise to 70 million by 2015.

While underweight continues to be a crucial problem in terms of burden of disease in developing countries, obesity is fast catching up and can hardly be ignored. In developing countries, the prevalence of childhood obesity in preschool children is in excess of 30 per cent. Thus, countries like India carry the ‘double burden’ of high levels of malnutrition caused by food insecurity and growing levels of obesity caused by diets high in sugar, oil and salt along with sedentary lifestyle.

Obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular diseases, insulin resistance and psychological effects, and the resultant non-communicable diseases such as diabetes, hypertension, strokes and heart disease are already contributing significantly to adult mortality. What is critical is that in countries like India, it diverts family resources from nutritious food to the empty calories of highly processed foods.

According to World Health Organization (WHO), effective population-based childhood obesity prevention strategies include restrictions on marketing of unhealthy food (biscuits and potato chips, for instance) and non-alcoholic beverages (soft/carbonated drinks) to children.

Further, the issue of conflict of interest in allowing the junk food industry to participate in policy-making has been continuously raised by civil society, and partially addressed by WHO in its documents. The WHO states that “concerns have been raised regarding the influence of for-profit companies — particularly from the food industry — on the priorities of obesity prevention interventions and the selection of strategies.”

In particular, it recommends that “mechanisms need to be in place to limit the influence of commercial interests and potential conflicts of interest in the policy-making process.” However, what remains worrying is the persistent blind spot with respect to the role of the junk and processed food industry, its rampant proliferation, and its constant attempts to influence nutritional policy and its emergence as a major funder of development programmes of agencies related to health and nutrition.

There have been numerous reports of conflict of interest related to the presence of big-food giants in decision making bodies of Pan American Health Organisation (an office related to WHO); Scaling Up Nutrition (SUN) movement, comprising governments, civil society, the United Nations, donors, businesses and scientists; and GAIN (Global Alliance for Improved Nutrition) which statedly supports market-based solutions for malnutrition and partners with UNICEF on numerous projects. Many of these relationships have been subsequently sanitised as a result of public protest.

On its part, the Indian government has stayed fairly clear from such associations and is not currently a part of the SUN Alliance. In fact, it made a statement at the recent World Health Assembly on the agenda item related to engaging with non-state actors, cautioning about indirect funding from the processed food industry.

However, closer home, concerns are just beginning to emerge. The Ministry of Health and Family Welfare has created a Reproductive, Maternal, Newborn and Child Health Coalition (RMNCH) that has a “mandate to provide and advocate for policy and programme directions to achieve improved RMNCH outcomes in India”. The Secretariat, (by order!) is to be based at a specifically-named NGO which is an established and well-respected child rights organisation, but one that is now funded by several fast food and pharmaceutical companies, among others, in direct violation of all principles of conflict of interest.

Why and how the choice of this particular agency was made by the government is also a mystery and one wonders whether any others were permitted to apply for the position and for how long the secretariat is to be housed with this NGO.

One of the most contested areas, between civil society groups concerned about commercial influences upon food policy and those who are looking for ‘market-based solutions’ and are votaries of commercial processed and ready-to-eat foods, has been the National Food Security Act. The Act carries a definition of ‘meal’ as “hot cooked meal or ready-to-eat meal or take home ration, as may be prescribed by the Central Government.”

Capturing public food market

The mention of ready-to-eat foods, it is feared, leaves the door open for food industries to step up their attempts to capture the large potential market of the public food schemes (mid-day meals and food delivered through the anganwadis).

Public pressure had resulted in the removal of stringent standards for micronutrient content of the food to be served to children from Schedule II of the Act. This was on the grounds that while quality standards are required and desirable, village women or self-help groups cooking/preparing these meals would not be able to demonstrate these standards since labelling and testing would not be available to them. A case was also made that additional micronutrient requirements are being met through national programmes run by the Ministry of Health, such as the Vitamin A and Iron supplementation programmes, and we need not meddle with the entire process of food production and distribution to meet these requirements. However, these stringent standards have been brought back through the draft rules that have been put up recently by the Ministry for Women and Child Development.

The problem of junk and processed, packaged food in India is reaching dramatic proportions with every tiny village shop laden with packets of potato chips and namkeen and carbonated drinks. Junk food is far cheaper and more immediately filling than the high quality protein and micronutrient sources. Any practitioner with field experience would know that biscuits are used as the commonest complementary food in slums and suburban areas since they are convenient for working women to hand out to children through the day.

It behoves the government to recognise conflicts of interest, eschew these ‘partnerships’ and focus on stringent regulation and accountability instead of validating junk food companies by accepting their money and proudly proclaiming them as allies. Similarly, a visible public-policy support is required for the public food programmes that clearly favour the use of fresh, culturally appropriate food with sufficiency and diversity, using local resources.

If we allow the dangerous global trends towards unhealthy, processed and packaged foods to overwhelm the food culture in India, the direct and indirect public cost is likely to be enormous. Let us choose to save our children while we still have the chance.

(Vandana Prasad is a former member (child health), National Commission for Protection of Child Rights)

Countries like India carry the ‘double burden’ of high levels of malnutrition caused by food insecurity and growing levels of obesity caused by diets high in sugar, oil and salt

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