The Escalating Health Threats from Ultra-processed and High Fat, Salt, and Sugar Foods: Urgent Need for Tailoring Policy

Are advertising policies affirmative in restricting the marketing of foods high in fat, salt and sugar (HFSS) in India?: evidence from SWOT Analysis

The regulatory Indian environment for advertising high fat, salt, and sugar (HFSS) foods and non-alcoholic beverages, on various media was reviewed. Identified national-level policies were categorised as mandatory or self-regulatory based on legal content. For each mandatory regulation, Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was undertaken to determine how existing policies could be strengthened to safeguard children from unhealthy food advertisements. Thirteen policies (nine mandatory; four self-regulatory) relevant to advertising in India were identified. Of the nine mandatory policies, Guidelines for Prevention of Misleading Advertisements and Endorsements for Misleading Advertisements, 2022, is the only policy that restricts HFSS food advertisements to children across all media. There are key shortfalls, including limited scope of 'child-targeted' advertisements and lack of criteria to define HFSS foods. A robust regulatory framework is needed to protect children from HFSS food marketing, not just what is 'directed' at them, with clear evidence-based food classification criteria.

Intake of ultra-processed food, dietary diversity and the risk of nutritional inadequacy among adults in India

OBJECTIVE

This study assessed diet diversity and consumption of ultra-processed foods and explored its impact on macronutrient intake and risk of micronutrient inadequacy.

DESIGN

Cross-sectional, non-probability snowball sampling.

SETTING

Nutrient intake was assessed using 24-h dietary recall method and diet diversity through FAO-diet diversity score (DDS). Mann-Whitney U test was used to assess differences in risk of inadequacy across gender. Spearman's rank correlation assessed associations between energy contributed by ultra-processed food and risk of nutrient inadequacy.

PARTICIPANTS

A total of 589 adults (20-40 years) belonging to upper-middle and high-income groups.

RESULTS

The average individual DDS was 4·4 ± 0·6. Most of the participants (>80 %) had intakes less than national recommendations of pulses/eggs/flesh foods, milk/milk products, fruits, vegetables and nuts. Ultra-processed foods contributed to 17 % of total energy intake, 12 % of protein, 17 % of carbohydrate, 29 % of added sugar, 20 % of total fat and 33 % of Na intake. The average risk of nutrient inadequacies for Zn (98 % v. 75 %), folate (67 % v. 22 %) and niacin (83 % v. 44 %) was higher among males than females (P < 0·001). The average risk of nutrient inadequacies for Fe (58 % v. 7 %), vitamin B6 (95 % v. 90 %) and vitamin A (68 % v. 44 %) was higher among females than males (P < 0·001). There was a positive correlation between energy contributed by ultra-processed food and risk of niacin (ρ = 0·136, P = 0·001) and folate (ρ = 0·089, P = 0·049) inadequacy.

CONCLUSION

Reformulating ultra-processed food to reduce fat, sugar and salt and increase micronutrients and behaviour change communication strategies that promote dietary diversity will improve micronutrient adequacy and diet quality.

Accelerating policy response to curb non-communicable diseases: an imperative to mitigate the dual public health crises of non-communicable diseases and COVID-19 in India

Non-communicable Diseases (NCDs) are a threat to public health and sustainable development. NCDs were equated to being a 'pandemic' before COVID-19 originated. Globally, NCDs caused approximately 74% of deaths (2019). India accounted for nearly 14.5% of these deaths. NCDs and COVID-19 have a lethal bi-directional relationship with both exacerbating each other's impact. Health systems and populations, particularly in Low- and Middle-Income Countries (LMICs) like India have among the highest burden of COVID-19. This narrative review tracks key policy and programmatic developments on NCD prevention and control in India, with a focus on commercially-driven risk factors (tobacco and alcohol use, unhealthy diet, physical inactivity, and air pollution), and the corresponding NCD targets. It identifies lacunae and recommends urgent policy-focussed multi-dimensional action, to ameliorate the dual impact of NCDs and COVID-19. India's comprehensive response to NCDs can steer national, regional and global progress towards time-bound NCD targets and NCD-related Sustainable Development Goals (SDGs).

Funding

This work is supported by the Commonwealth Foundation. None of the authors were paid to write this article by a pharmaceutical company or other agency. The authors were not precluded from accessing data and accept responsibility to submit for publication.