India is second among the top five global markets for sugary beverage manufacturers. And, this is pushing the burden of double malnutrition — obesity and underweight — in the country. These facts have been noted in the latest Lancet series released on December 16, 2019. India is also one of the 15 countries where the double burden is on the rise, according to the series.
While the per capita sale of sugary beverages in India is low as compared to other countries, the total market sale is highest after China, Barry M Popkin, an American professor on nutrition, told Down To Earth. The per capita consumption is also rising fast.
“These countries are expected to become major markets for sugary beverages in the next decade. The speed of change is particularly important in understanding how this nutrition reality is shifting,” the four-paper series of The Lancet stated.
The overall consumption of ultra-processed foods, retail revolution which led to the emergence of large and small food retailers replacing fresh markets, and a very marked change regarding who controls the market are majorly contributing to disturbing nutrition levels.
“Case studies from China, Bangladesh, and India were the first to remark on this transformation and later research showed similar trends in Africa. These studies showed that the global and national public sectors were no longer the major influences of diets in Low-and-middle income countries (LMICs). Rather, food retailers, food agribusinesses, global food companies, and the food service sector and their domestic local counterparts have contracts directly with farmers,” the report said.
The Lancet said factors such as urbanisation, migration to cities, income growth, infrastructure improvements and trade liberalisation in LMICs, which include India, had upped private investment in the food sector. This, when put in context with the rising consumption of ultra-processed foods, made the pattern clearer.
Curiously enough, it identified another factor — working women. “Equally important is how the increase in the number of women working outside the home and the value of their time in work have shaped the demand for food that is ready to eat or ready to heat. Monteiro calls this convenience in food preparation and consumption the ultra-processed food revolution,” the paper said.
The food items sold outside schools was also exacerbating the menace as they were of poor nutritional quality. “Evidence from Brazil, Iran, Mexico, Haiti, Guatemala, India, South Africa, and the Philippines shows that foods sold by vendors in and outside of schools include chips, cookies, crackers, ice cream, fried foods, sugary drinks, hamburgers, pizza, and confectionary,” the report said.
Regarding the quality of meals served in schools, it said there was ‘surprisingly little information’ in LMICs.
In the second paper of the five-paper series, The Lancet said that malnutrition was not just a challenge in itself but was also increasing the existing burden of non-communicable diseases (NCDs). The authors of the paper drew attention to a study done in Pune in three cohorts.
Due to multigenerational exposure to energy scarcity and micronutrient deficiencies, a little less than one-third of the 663 young adults had developed pre-diabetes and 15 per cent of 100 young mothers had gestational diabetes in the rural cohort.