Why India’s new dietary guidelines limit sugar intake to 5% of daily calories, none for children under 2 years

Recently, Nestlé, the global food conglomerate, has come under scrutiny for adding sugar to its powdered baby food products, such as Cerelac, in lower-income countries such as India, while leaving it out in richer countries.

This revelation has prompted the Food Safety and Standards Authority of India (FSSAI) to re-evaluate its regulations on sugar in packaged foods.

Remarkable, a joint study by Public Eye and the International Baby Food Action Network (IBFAN) released last month, found that “in India, where sales of Cerelac (powdered baby food for the 6-24 month age group) exceeded $250 million in 2022, all Cerelac baby cereals contain added sugars, an average of almost 3 grams per portion”.

In its defense, Nestlé India has issued a statement saying it has reduced added sugars by up to 30 percent, depending on the variant, in its portfolio of cereals for babies (milk cereal-based complementary foods).

“We regularly review our portfolio and continue to innovate and reformulate our products to further reduce added sugar levels without compromising quality, safety and taste,” the food company said.

Meanwhile, a senior FSSAI official told ThePrint that in the backdrop of the Nestle controversy, one of its scientific panels was looking into the matter and may recommend a policy change, if deemed necessary.

In response to a query to CEO G. Kamala Vardhan Rao to understand the official position of the authority, FSSAI shared its FSS (Foods for Infant Nutrition) regulations.

It said that lactose and glucose polymers – types of carbohydrates – “will be the preferred carbohydrates for infant nutrition foods. The regulation also says that sucrose and/or fructose may not be added unless necessary as a carbohydrate source, and provided that the sum of these does not exceed 20 percent of the total carbohydrates.”

However, nutrition experts such as Dr Arun Gupta, national chairman of food think tank Nutrition Advocacy in Public Interest (NAPi), pointed out that there are clear loopholes in the existing standards in India, which companies are taking advantage of.

He underlined that the WHO provides specific advice on a healthy diet for infants and children, saying that from the age of six months breast milk should be supplemented with a variety of adequate, safe and nutritious foods, and that salt and sugars should be excluded being added. to complementary foods.

Despite this, India’s Food Safety and Standards Regulations (Foods for Infant Nutrition) 2020 allow the addition of sucrose and/or fructose up to 20 percent of total carbohydrates or 13.6 grams of sugar per 100 gram serving.

Gupta said that no packaged food with added sugar should be allowed at all infants. Furthermore, he added, given the escalating non-communicable disease crisis in India, the products for older children and adults should also carry clear warnings on the front of the package label (FoPL) stating whether they are high in fat, sugar, and salt (HFSS).

Also read: Keep babies away from sugar and 500 grams of fruit and vegetables per day – new national dietary guidelines after 13 years

Damage caused by sugar

In India, 56.4 percent of the disease burden is directly related to diet, the 148-page ICMR-NIN guidelines point out.

Another study by the ICMRin collaboration with the Madras Diabetes Research Foundation, released last year, revealed that one in four Indians is diabetic, pre-diabetic or obese – conditions linked to dietary habits and a sedentary lifestyle.

Moreover, there is also sufficient evidence to establish that feeding infants and young children food products loaded with added sugars puts them at greater risk of early childhood obesity and non-communicable diseases later in life.

Additionally, the American Heart Association recommends that adult women should consume no more than 6 teaspoons (about 25 grams) and men no more than 9 teaspoons (about 38 grams) of added sugar daily.

Despite these guidelines and warnings, many packaged foods, including unexpected ones, contain added sugars such as sucrose and high fructose corn syrup (HFCS).

Dr. Tushar Tayal, Principal Consultant, Department of Internal Medicine, CK Birla Hospital, Gurugram, explained that the liver is the only organ that can metabolize sugar in significant quantities.

“When your liver becomes overloaded, it turns the sugar into fat. Some of that fat can settle in your liver and contribute to fatty liver disease. High sugar consumption is also linked to insulin resistance, metabolic syndrome, obesity and type 2 diabetes,” he said.

In addition, it promotes oxidative stress, inflammation, higher serum uric acid levels, hypertriglyceridemia and higher systolic blood pressure. Moreover, high sugar levels cause resistance to leptin hormones, Tayal points out.

Leptin is a hormone that sends signals to your brain when you need food or when you are full. Leptin resistance, on the other hand, makes you feel hungry and eat more, even though your body has enough fat stored.

Worse still, because refined sugar is an already digested form of sugar, it causes a rapid spike in sugar levels, which is extremely harmful for diabetics, experts say.

Scientifically, added sugar in food products can cause more harm to health compared to natural sugar as they add excess calories without providing essential nutrients, explains Seema Gulati, head of the nutrition research group at a Delhi-based non-profit organization National Diabetes, Obesity. and Cholesterol Foundation.

Gulati added that natural sugars in fruits and dairy products are packed with fiber, vitamins and minerals, which can mitigate some of their negative effects if consumed in moderation.

Meanwhile, the ICMR-NIN guidelines addressed the increase in consumption of highly processed foods, sedentary lifestyle and limited access to various foods, contributing to micronutrient deficiencies and rising obesity rates in India.

The guidelines also highlighted concerns about aggressive advertising and marketing of these unhealthy foods through various media channels, including social media, which influences the dietary preferences of children and adults, leading to harmful long-term effects.

Considering this context, Gupta pointed out that there are hardly any cases where FSSAI has penalized food companies for misleading advertisements. He also expressed disappointment over the delay in implementing the FOPL policy, which, he said, would at least inform consumers and help them choose what they eat.

Also read: Gutkha, paan masala solution: Policy reform could save Indian users $19 billion in healthcare costs, study shows

Scientific limit values ​​are needed for sugar, salt and fat

Several nutritionists insist that scientific ‘cut-offs’ for salt, sugar and fats in processed foods are mandatory if India is to curb the raging pandemic of lifestyle diseases.

According to Gulati, there are gaps in enforcement or limitations in the scope of food regulation. “It is essential for regulators to continually review and strengthen regulations regarding added sugar, salt, trans fat and other harmful ingredients to protect public health. Collaboration between government agencies, health experts and industry stakeholders is crucial to effectively address these issues,” she emphasizes.

Meanwhile, Ashim Sanyal, Chief Operating Officer (COO) and Secretary of Consumer Voice, a Delhi-based consumer organization, pointed out the regulatory gap in controlling high sugar, salt and fat contents in packaged foods, which are a daily routine become. indispensable for many.

“The FOPL policy has been suspended, probably due to industry pressure,” he claimed, adding that more sugar, salt or saturated fats are addictive and easy to consume.

While the experts highlighted concerns over food regulations, evidence linking ultra-processed food (UPF) to non-communicable diseases, including cancer, has also emerged in the country in recent years.

A 2023 WHO report indicated that India’s UPF sector, which includes chocolate, confectionery, salty snacks, beverages, ready-to-eat meals and breakfast cereals, witnessed a compound annual growth rate (CAGR) of 13.37 percent in retail value between 2011 and 2021.

In addition, according to the Nova Food Classification System – a widely used system that rates food based on the degree of processing – UPF includes edibles of primarily industrial origin, made largely or entirely from substances derived from foods and additives using a range of processes and that minimal whole food.

According to Sanyal, the least FSSAI can do is warn consumers by implementing FOPL so that they can make decisive choices based on their health concerns. “Consumers often encounter food products whose nutritional value is not even stated on the packaging,” he emphasizes.

As a result, consumers have little guidance to help them make informed choices about sugary and refined products, Sanyal told ThePrint, stressing that: “It should be mandatory even for restaurants and home chefs to verify the basic nutritional values ​​of their products to report.”

(Edited by Richa Mishra)

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