Fat, fact and fiction

The Kerala government has announced a 14.5 per cent ‘fat tax’ on burgers, pizzas, donuts, tacos, sandwiches and pasta served in branded restaurants. As Kerala having the second highest rate of obesity in India, this new tax is termed as a preventive measure by the state government. Public health campaigners in urban India welcomes this step as India stands third place with highest obese population after U.S. and China. “Public health,” as defined by World Health Organization (WHO), is “the science and art of preventing disease, prolonging life, and promoting health through organised efforts of society”. One of the well- known approaches to public health is regulatory or legal approach.

In the globalisation process, food habits have undergone a sea change and have impacted Indian lifestyle in general and food habits of urbanites in particular. Fierce marketing techniques by food manufacturers, coupled with enticing messages of mass media, have culminated in increased sales of junk food. Needless to emphasise, junk food is posing a threat to the wellness of individuals. Junk foods include salted snacks, burgers, pizzas, fried fast food, donuts, tacos, sweet desserts, sandwiches, pasta carbonated beverages etc. According to National Institute of Nutrition’s revised dietary guidelines for Indians, “junk food is unhealthy food”. Junk foods are those containing little or no proteins, vitamins or minerals but are rich in salt, fats and are high in energy (calories).

Junk foods- Health risks The more highly processed items usually fall under the junk food category. Junk food largely depends on the person’s class and social status, with a rich people tending to have a broader definition while consumers belonging to lower-income may see fewer foods as junk food, especially certain ethnic foods. Junk foods may not pose any immediate health concerns when integrated into a well balanced diet with adequate nutrients. But, consumers of junk food are less likely to eat healthy foods like fruits and vegetables and dairy products. As a result, excess consumption of junk foods, coupled with low levels of physical activity, can lead to obesity. Obesity, in turn acts as gate-way for non-communicable diseases (NCD) like hypertension, diabetes, heart diseases and certain types of cancers. Hence, natural foods are to be promoted and junk foods are to be discouraged.

Nutrition (not only food) is a basic human need and a prerequisite to a healthy life. A balanced diet is one which provides all the nutrients in required amounts and proper proportions. Indian traditional meal, whether south Indian or north Indian; vegetarian or non-vegetarian represents the balanced diet. Furthermore, even the home-made snacks for children made with groundnut, gingili seeds (til), and jaggery contain good protein. But, traditional foods rich in nutrition are slowly fading out of Indian kitchens. In India, until 1990’s most adolescents and adults had nutrient-rich home-made snacks and were well-integrated in society. Non-availability of traditional foods coupled with lack of awareness is resulting in westernisation of Indians eating habits. Moreover, pizzas and burgers are replacing traditional Indian diets and being consumed as total alternate for lunch or/ and dinner by most of the urban consumers. That means, the essential nutrients they are supposed to get from their indigenous diet is replaced by little or nil nutrient pizzas and burgers. Whereas, Indian snacks like vada pav, though termed as junk food is not as prevalent as pizzas and burgers.

Importing ailments By imbibing eating habits of the West, youngsters are succumbing to disorders like Inflammatory Bowel Disease (IBD) that were hitherto predominant in advanced countries and unheard of in India. Young people are literally importing ailments while imbibing eating habits of the West. IBD occurs due to inflammation (redness and swelling) of the large or small intestine leading to constipation, diarrhoea, blood in stools or pain in the stomach, loss of appetite, weight loss and even anaemia. Interestingly, doctors point out that IBD is less in villages when compared to cities and common in a young demography (16-45 years). According to various forecasts, by 2021, the burden of disease of IBD is expected to reach 13 millions in India. As per WHO, the number of overweight or obese young people increased from 31 million globally in 1990 to 44 million in 2012. The worrying aspect is that a vast majority of overweight children live in developing countries (including India), where the rate of increase has been over 30 per cent higher than that of developed countries. The WHO predicts that if current trends continue, the number of overweight or obese children globally will increase to 70 million by 2025. Keeping this in view, as a precaution, globally, countries have put in place certain norms like banning junk food in schools (USA, UAE, England, Canada); regulating advertisement and promotion (Canada, England, South Korea, Peru, France) and imposing taxes (Denmark, Finland, France, Mexico, Peru).

Awareness is the key Globally, calorie-laden diets are generating more ill-health than physical inactivity, alcohol and smoking combined. In India, urban population is turning to be more sedentary with little or no physical activity. Changing lifestyles of people, both in rural and urban areas are seen to transform the very structure of our society at a rapid pace today. The shift from traditional to ‘modern’ foods, changing cooking practices, increased intake of processed and ready-to- eat foods, intensive marketing of junk foods and aerated beverages have affected people’s perception of foods as well as their dietary behavior. Irrational preference for energy-dense foods and those with high sugar and salt content pose a serious health risk to the people.

The increasing number of overweight and obese people in the community and the resulting burden of chronic non- communicable diseases (NCD) necessitate systematic nutrition educational interventions on a massive scale. Spreading awareness among the people, particularly among women and adolescents, is the key to face the challenge of “westernization of food habits”. In this scenario, in Kerala, “fat tax” and creating awareness among people should go hand in hand so as to have a maximum impact. Without one (awareness); the other (fat tax) would not make a difference.

(The writer is Deputy Director, National Institute of Nutrition, Hyderabad)