Obesity in children: Paediatricians bat for nutrient-specific labels on packaged food

Mumbai Paediatricians from around the country are batting for inclusion of nutrient-specific warning labels on packaged foods as a way to counter the obesity pandemic among Indian children.

They recommend easy-to-interpret symbols (similar to a green dot for vegetarian food and red dot for non-vegetarian) to indicate whether a food item is healthy for children in terms of sugar, salt, caffeine and saturated fats levels, and calorific value.

The Non-Communicable Diseases Prevention Academy (NCDPA), a subspecialty of Indian Academy of Paediatrics (IAP), has written to Food Safety and Standards Authority of India (FSSAI) to consider necessitating nutrient specific warning on labels of all packaged food.

In their communication, the NCDPA expressed concern about the harms of current food labelling practices on the health of children. The prevalence of obesity and associated non-communicable diseases like diabetes and hypertension among Indian children, which was already shockingly high, is on a rise in the post-pandemic period, warns IAP which is a body consisting of more than 35,000 paediatricians from around the country.

According to the National Family Health Survey 5 (NFHS5) conducted in 2019-2020, 3.4% of all children under five in India are overweight, as compared to 2.1% in NHFS4 (2016-2017).

The IAP blames the easy availability of ultra-processed foods with insufficient nutrient information on the labels. This has led them to advocate for making nutrient-specific warning labels of packaged food a norm.

Often food labels include nutritional information based on the recommended daily allowance (RDA) of adults or adolescents. For example, a food item is considered healthy when it has around 2,000 calories, two grams of sodium or five grams of salt, less than 5-10% RDA for sugars and less than 10% RDA for saturated fat.

However, it considers the daily nutritional requirements of an adult and may not be very healthy for young children. A toddler or a child younger than 10 years can easily pile on weight if they consume such foods regularly.

There is scientific evidence that every 1% increase in the purchase of ultra-processed foods results in a 0.25% increase in the prevalence of obesity, said chairperson of academy Dr Rekha Harish. She also raised concern over how such foods are marketed towards children and are endorsed by some of the most popular celebrities of the country.

“Even educated people are not aware about the recommended daily allowances of nutrients and micronutrients that an adult can consume, let alone that for children. Therefore, it would be a good practice to include symbols that can be easily interpreted to understand whether a food item has an excess of sugar, salt, saturated fat or caffeine,” said Dr Harish.

She also informed that a similar labelling practice has been found effective to counter childhood obesity in countries like Chile and Israel. At the same time, she feels that labelling conventions like the health star rating system used in countries like Australia should be avoided as they tend to be easy to manipulate.

Talking about how the pandemic has worsened the obesity epidemic among Indian kids, Navi Mumbai-based paediatrician and incoming president of IAP, Dr Upendra Kinjawadekar said, “During the lockdown, children were not able to get any exercise, had increased screen time due to online classes and had access to a lot of junk food.”

He said that labels on packaged food are often misleading and sometimes just outright disregards the labelling requirements. “Even when they do mention things like the calorific value of a food item, parents are not even aware whether they are safe for children in terms of individual constituents being too high for the recommended daily allowance (RDA) of a child. Parents need to educate themselves about how to read labels,” he said.