ICMR Proposes Limit on Sugar in Ultra-Processed Foods, Experts Welcome Move

The revised guidelines define ultra-processed foods, and recommends a threshold for sugar in packaged foods.

IMCR dietary guidelines on ultra processed foods, and non-communicable diseases

(Photo: iStock)

In a first, the National Institute of Nutrition (NIN) and the Indian Council of Medical Research (ICMR) have revised the dietary guidelines they put out earlier this month to include a recommended threshold for sugar, fat, and salt in packaged foods.

The guideline also defines what ultra-processed food is, and underscores its role in the rise of non-communicable diseases (NCD) like diabetes, cancer and cardiovascular diseases in India.

Commenting on the guidelines, Dr Arun Gupta, Convener, Nutrition Advocacy in Public Interest, and former member of Prime Minister’s Council on India’s Nutrition Challenges, tells FIT, "The revised guidelines are a great step forward and provide a clear-cut definition of ultra-processed food products and HFSS-foods high salt, sugar, and fats, which India did not have."

What do the guidelines say about ultra-processed foods? What are the restrictions recommended for packaged foods? What is the rationale behind them? FIT speaks to experts to break it down.

Dr Priyanka Rohatgi, a nutritionist based in Delhi goes on to explain, "These guidelines have been ​drafted based on a set of 17 detailed guidelines recommended by a multi-disciplinary committee owing to the significant disease burden Indians are facing due to changed dietary habits and food choices," adding that it's comprehensive and covers all bases.

"I think the whole guideline stands out to me in a way because it is interesting to see the official government's position on the nutritional guidelines in terms of what you should eat, what is harmful. From what kind of water you should drink, to what kind of products to avoid," adds Dr Gupta.

Ultra-processed Foods and India's NCD Burden

The guidelines point out that there's been a sharp increase in NCDs, particularly obesity and diabetes in India in the past few years.

According to the guidelines, around 25 percent of Indians are either overweight or obese, while abdominal obesity is prevalent in 53 percent of urban adults and 19 percent of rural adults.

It also says that in India, 10 percent of children between the ages of 5 to 19 years are prediabetic.

It links this alarming trend to the increase in consumption of Ultra-processed foods (UPFs).

UPFs are broadly understood to be any packaged food product that goes through multiple levels of processing, ranging from jams, mayonnaise, and cheese to soft drinks, chips, and ready-to-eat meal boxes.

"If it is food that is being advertised, it's likely ultra-processed," says Dr Arun Gupta.

Mounting research, in recent years, has found strong links between UPFs and ill health because they typically contain additives such as emulsifiers, preservatives, flavourings and colouring.

According to ICMR, regular consumption of UPFs is associated with obesity, a higher risk of coronary heart disease (heart attack), cerebrovascular diseases, diabetes, and even accelerated ageing.

Experts have, in the past, also linked UPFs to gastrointestinal issues.

However, up until now, there was no clear definition of UPFs and which foods could be categorised as such. The revised guidelines define it clearly.

"UPFs refer to food and beverage products that have undergone extensive industrial processing and contain a high number of additives such as preservatives, sweeteners, colorings, flavorings, emulsifiers, and other substances that are not commonly used in culinary preparations."

NIN-ICMR Dietary Guidelines

The guidelines also say that UPFs are especially damaging because, they are usually high in fats, sugar, salt, as well as low in micronutrients and fibre and mostly calorie dense".

"The thresholds are provided for both solids and liquids which should now be used for developing regulations on of marketing as well as Front-of-Pack warning labels of pre packaged food products. These are also helpful for public education of which foods are unhealthy even as cooked."

Dr Arun Gupta, Convener, Nutrition Advocacy in Public Interest (NAPI) India

These caps could potentially impact popular UPFs such as soft drinks, juices, chocolates, cakes, ice-creams, breakfast cereals and even health drinks.

The Role That Aggressive Marketing Plays

While they say these products are harmful, the guidelines also recognise that these products are aggresively marketed in India.

"Recognising the impact of aggressive advertising and marketing of unhealthy foods and how they influence dietary preference, especially among children and adults right at the beginning is an important point," says Dr Gupta.

The guidelines mention that this can "lead to detrimental affects in the long term and non-communicable diseases."

Speaking to FIT for a previous story, Dr Ashwini Setya, Adjunct Professor in Gastroenterology, ESIC Medical College, Faridabad, said, "advertising of ultra-processed food should be regulated, and there should be no loophole for surrogate advertising as well."

“Like how tobacco has been advertised through other symbols all these years, that shouldn’t happen with ultra-processed foods.”

Dr Ashwini Setya, Adjunct Professor in Gastroenterology, ESIC Medical College, Faridabad

'Need to Put the Guidelines to Action' 

Dr Gupta says the guideline, "is of great value for public health."

"It is a timely reminder to the regulators now to do something which has been pending for ages," he says.

However, he underscores the importance of turning these guidelines into actionable measures.

On 10 May, Nutrition Advocacy in Public Interest (NAPI) India sent a letter to the health ministry urging them to use the guidelines to develop regulations to prohibit advertising of ultra-processed and HFSS Foods.

"It's now it's for the regulators to use these guidelines to regulate these UPFs. If our policymakers and health regulators do not use it to address gaps in policy, then it would a very unfortunate waste," finishes Dr Gupta.