Warning Labels for Unhealthy Packaged Foods: A Must

A loud and clear ‘position’ of prominent Indian public health and consumer bodies to protect from the harms of junk foods.

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Twenty-two Indian public health and consumer organisations opposed FSSAI’s plan to label ultra-processed foods with a ‘Health Star Rating’ designed to mislead and confuse consumers.

A position statement endorsed by several experts and organizations on ‘Front-of-Pack Labelling (FOPL) on Unhealthy Food/Drink Products’ was released today by the Nutrition Advocacy in Public Interest (NAPi) through a press conference held at Indian Women’s Press Corps.

“We at NAPi, believe that FSSAI has gone wrong both in its approach and the decision to include ‘Health Star Rating’ on unhealthy food and drink products. We are pleased to share that prominent public health and consumer bodies from across the country have come together against this irresponsible move,” said Dr. Arun Gupta, convener, Nutrition Advocacy in Public Interest (NAPi), presenting the position statement.

The statement firmly opposes recently announced plans of the Food Safety and Standards Authority of India (FSSAI) to adopt a ‘Health Star Rating’ (HSR) instead of a ‘Warning Label’, as a front-of-pack label for packaged foods high in salt, sugar or fat.

“Packaged food products, which are high in unhealthy fats, salt or sugar and several of which are ultra-processed, damage health in many ways – from reducing immunity to increasing the risk of heart disease, diabetes, obesity and certain cancers,” said Prof. K Srinath Reddy, President of the Public Health Foundation of India (PHFI), who released the statement to media.

“Star ratings can be misleading, as they do not inform the consumer whether the rating is for specific constituents, taste or shelf life. The consumer’s right to judge the health risks posed by any packaged food product is not served by the star ratings”, added Prof. Reddy.

Developed by the NAPi in consultation with endorsing organisations, this joint statement adds to the growing criticism of FSSAI’s announcement to go ahead with ‘Health Star Rating’, which can mislead the consumer.

“Individual components like fiber, fruit, vegetable or nuts added to a fundamentally unhealthy food product in the name of positive nutrients, may give a false impression of the food being healthy which can lead to overconsumption of such food products”, said Dr. Vandana Prasad, community pediatrician, Public Health Resource Network, while adding to the misleading nature of Health Star Rating

Health Star Rating (HSR) Labels can’t be a solution for Indian consumers, says George Cheriyan, “We should learn from the experiences of Australia and New Zealand and be cautioned against the adoption of HSR. Indian regulators must choose a simple and interpretive label that aids consumers in rejecting unhealthy products.” 

Experts from across the country favour nutrient-specific ‘Warning Labels’, which effectively reduce the consumption of junk foods.   

“Since there is stronger evidence that Warning Labels can impact consumer behaviour towards more healthy diets, the food industry can influence decision making through the stakeholder consultations where it occupies a majority status”, added Dr. Prasad while commenting on the policy-making process.

Dr Remesh Kumar president of the Indian Academy of Paediatrics (IAP) said, “IAP endorses Warning labels on packaged foods and NOT health star rating (HSR) system. The food industry might like the stars on unhealthy food products, but we believe Warning labels should be used, as this is what scientific evidence tells us. FSSAI May reconsider its decision on HSR“,

“Considering obesity to be a significant driver of morbidity and mortality, people should be able to identify foods with high calories and harmful ingredients. Warning labels are a reliable way to identify harmful foods. The need of the hour, said Dr. B.G. Dharmanand, President of the Indian Rheumatology Association (IRA) from Bangalore.

Supporting the point on warning labels, Prof (Dr) Vitull K. Gupta, said, “Junk foods, ultra-processed foods, nutritionally inappropriate foods and caffeinated, coloured, carbonated or sugar-sweetened beverages necessitate creating a healthy food environment supplemented by warning on the front of pack label (FOPL)”. Prof. Gupta is Chairman of the Association of Physicians of India (Malwa Branch) and a Health and Human rights activist.

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The importance of providing practical and straightforward information to consumers, said Vasundhara Raghavan of Kidney Warriors Foundation from Mumbai. “It is well established that for consumers to make an informed decision at the point of purchase, the labels should be interpretive and provide judgments about the unhealthy nature of the product to make an informed choice.”

The statement points towards substantial scientific evidence showing that increased consumption of ultra-processed unhealthy food/drink products is associated with high risks of NCDs and all-cause mortality. It also shows that warning labels are most effective in reducing the consumption of unhealthy food products, and Health Star Ratings fail to do so.  

“Food industry is not interested in such information to the consumers as it may hit the bottom-line and is happy with HSR, which is confusing and can be manipulated. Therefore, FOPL must be mandatory and not left to the industry as voluntary”, added Professor HPS Sachdev, member of NAPi, while emphasizing the need for mandatory regulation.

The statement also calls for a timely law for warning labels; adoption of thresholds based on the nutrient profile model of the World Health Organization developed for the South East Asia Region; immediately stopping the marketing of unhealthy foods targeted at children, and absence of conflict of interest while making decisions related to public health. It outlines the concern that about 60 per cent of annual deaths in India are due to non-communicable diseases (NCDs) and more than half of 5-19 years old Indian children have elevated biomarkers of NCD.

“India can’t afford the epidemic of obesity and non-communicable diseases. Health Star Rating will help the junk food industry legally sell its bad food as good food. FSSAI can’t allow this. It must come forward and show that it cares for the health of the Indian consumer. It will have to act strongly to counter the industry pressure and fulfil the mandate given,” said Sunita Narain. Director-General, Centre for Science and Environment (CSE).