The food and beverage industry is fuelling childhood obesity, blood pressure and diabetes by promoting use of packaged goods laden with trans fats, sugar, and salt, according to Dr Shweta Khandelwal, research scientist, Public Health Foundation of India. She was quoting from Chronic Conditions in India – Evidence Based Solutions for a Growing Health Crisis, a joint report released in New Delhi on Tuesday.
The report was released by minister of state for science and technology Y S Chowdary after launching Centre for Control of Chronic Conditions (CCCC), a centre focussed on generating knowledge and awareness about chronic diseases in India.
Both the initiatives, the report and CCCC, are developed through international partnership between four leading institutions - the All India Institute of Medical Sciences, New Delhi; Emory University; London School of Hygiene & Tropical Medicine; and Public Health Foundation of India.
Among other things, the report looks at the rising tide of chronic conditions in India and argues that the cost of inaction towards chronic conditions would be too high for India to bear.
Khandelwal explains, “Wrong diet or trans fat foods are hugely responsible for pumping in all sorts of unhealthy concoctions touted with unchecked health claims. Scientific evidence shows that food and beverage industry is fuelling childhood obesity, blood pressure and diabetes very early on by promoting use of packaged goods laden with trans fats, sugar, salt, and saturated fats. This unhealthy environment predisposes us to chronic disease risk factors and events.”
She adds, “Wrong type of oil selection is an important risk factor. Subsidised oils are usually promoting dyslipidemia, bad cholesterol, etc. Indians are as it is predisposed to higher chronic disease risks than other ethnicities. Saturated and trans fats are bigger contributors than overall oil intake. Type of fat along with quantity is of prime importance.”
With regard to gutkha and tobacco ban, Khandelwal states, “I strongly support the ban but long-term high level commitment must not to dilute this ban. Also I would request agriculture and health department about long- term strategies on advertising control, promoting locally available healthy whole grains, fruits, and avoiding processed goods. Subsidies on healthy options and taxes on high salt, sugar and fats are what I propose.”
Lauding the international collaboration, Prof. M C Misra, director, AIIMS, comments, “India alongside other developing nations has not yet got over infectious disease burden in all age groups and childhood in particular. It is also projected that India and China will house largest proportion (>80%) of elderly population with all antecedent health issues, which would include chronic disease burden, which has not been witnessed earlier. India has already passed the early stages of a chronic disease burden (diabetes, stroke, cardiovascular diseases, mental health illness etc.).”
Misra points out, “As if that was not enough we face injury epidemic in the current millennium. If we go by the number today, injury has become a major public health problem in developing countries as also in developed countries. Developed countries have done well by formulating and enforcing injury prevention strategies. Realistic dimension of injury burden has not been well appreciated. Injury epidemic is real in developing countries and 88% of injury burden remains in Asia, which is contributed largely by India and China, two populous nations and developing economies.”
He adds, “When we compare death in all age groups, injury is at No. 3, but when it comes to years of productive life lost and Disability Adjusted Life Years (DALYs) due to injury, it exceeds both put together cancer and heart disease together. In view of the implications for future disease burden and the demographic transition that is in progress in India and globally the agenda of chronic diseases and injuries should be a priority. This international collaboration between AIIMS, Emory University, LSHTM and PHFI will be the beginning to strengthen institutional framework, national and international capacity building and networks in the regions that will translate evidence into policy and practice.”
Chronic conditions is now the leading cause of death in India, accounting to more than 5 million deaths each year – which is over 53% of all deaths. This is projected to rise to almost three quarters of deaths by 2030. They are also a leading cause of disability.
In his address, Prof. James Curran, dean, Rollins School of Public Health, Emory University, Atlanta, USA, states, “The challenge of chronic conditions confronting India cannot be overstated. It is assumed that chronic conditions are diseases only affecting rich countries or the rich people in poor countries. Evidence now tells us that this is untrue. Chronic conditions are now a global challenge and there is a pressing need for greater understanding on how it affects people, and even threatens to undermine economic development. There is also an urgent need to advocate the integration of best practices for various chronic diseases and injuries with one another as India progresses with its national health agenda, hence this international partnership serves as a platform that will try and make a real difference to health outcomes in this enormously important area.”
The secretariat for this global partnership will be at the Public Health Foundation of India. CCCC is multi-disciplinary group of researchers and health professionals representing a spectrum of clinical, public health, genetics, biochemistry and social science disciplines. The work focusses on the priority chronic conditions of cardiovascular diseases and stroke, mental disorders, diabetes, chronic lung diseases, cancers, injuries and chronic kidney diseases.
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