Getting India to eat better

The Eat Right Movement aims to usher in a new food culture by nudging both businesses and consumers to opt for healthier products 

Alarmed by a rise in lifestyle diseases, the FSSAI has launched the Eat Right Movement, and food companies around the country have pledged their support.

In November last year, top officials at the Food Safety and Standards Authority of India (FSSAI) sat up when they flipped through the pages of the India State-level Disease Burden report. While life expectancy had gone up, more Indians were dying of non-communicable diseases such as ischemic heart disease, chronic obstructive pulmonary disease (COPD), stroke, diabetes, and chronic kidney disease, the report stated. “Dietary risks, which include diets low in fruit, vegetables and whole grains, but high in salt and fat, were India’s third leading risk factor for health loss in 2016,” the report says.

Diabetes, in particular, has become India’s fastest-growing disease since 2000, according to a study released in 2017 by two research institutes – The Indian Council for Medical Research and the Institute for Health Metrics and Evaluation – and advocacy group Public Health Foundation of India. The same year, the International Diabetes Federation claimed there were over 72 million cases of diabetes in India, a number which, some experts say, will almost double by 2025, if current dietary trends continue. These numbers forced the food safety regulator to not just accelerate its ongoing draft regulation on labelling packaged foods with high fat, sugar and salt (HFSS) content with red dots, but put their best minds together to draw up a larger plan.

On July 10, the Eat Right Movement was launched to usher in a ‘new food culture’ by nudging businesses and consumers to cut down on salt, sugar and Trans fat in their food. In a video on the campaign’s website, actor Rajkummar Rao, the pro bono ambassador for the ‘movement’, as the stakeholders like to call it, recites the campaign’s tagline – ‘Aaj se thoda kam.’ The idea is not to go cold turkey but slowly and steadily reduce the amount of salt and sugar that you eat, which should be easier for people to follow. In the video, Rao asks whether the heart or the head should decide what you eat, concluding that health is a matter of the mind, so be smart about what you eat.

While government agencies have often laid down regulations for foods industry to push for healthier options, what has remained unaddressed is awareness among consumers. The Eat Right Movement aims to strike that balance. “It is the classic chicken-and-egg case. Consumers complain they do not have healthy options when they eat out or buy packaged food whereas the businesses say consumers do not want healthy options. So we thought how can we break this cycle? Businesses will have to take the first step and consumers have to become more aware of what they eat,” says Pawan Agarwal, CEO, FSSAI.

As a team at FSSAI fleshes out draft regulations on menu labelling and strategically bringing down high fat, salt and sugar content, the regulator reached out to industry, inviting voluntary commitments to initiate the process right away instead of waiting for the regulations to come into effect. “The labelling regulation was already being considered, but we thought if we wait for that to happen, it will take a year. We began to nudge the food businesses to start working towards healthier options. It had two major advantages. When they begin product reformulation in a few months, we at FSSAI will understand the practical problems in implementing it, and that will help us bring in regulations with reasonable thresholds,” Agarwal says.

An issue that created further complications was that the draft regulations received pushback from food companies because none of them wanted their food labelled red, or unhealthy. “According to thresholds in draft regulations, a significant part of their portfolio was being labelled red and hence, they were concerned,” Agarwal says. “If, as a regulator, we say that 80 per cent of the food available in the market is unhealthy, either consumers will ignore it completely or will have limited choice. We do not want a situation where we have standards or thresholds that are significantly different from current practices because reduction of HFSS will happen only over a period of time.”

With the World Health Organisation calling for a complete removal of Trans Fat from the food supply by 2023, the edible oil industry, bakeries and halwais in India, including Halwai Association and Hotel and Restaurant Association of Northern India, too, have pledged to do their bit, committing to phase it out by 2022 with the pledge ‘India@75 – freedom from trans fat by 2022.’

“As far as Trans fat is concerned, we are coming up with regulations where edible oil cannot have more than two per cent of Trans fat and final food or bakery products will have not more than 0.5 per cent. As soon as these standards are put in place, businesses will have to adhere to it and if they don’t, it will be a violation of the Food Safety Act and they will be liable for prosecution,” Agarwal says.

Fifteen companies from the packaged food industry – Nestle, Mapro, MTR, Britannia, Bikanervala, Patanjali, Bagrry’s, Hindustan Unilever, Weikfield, Kraft Heinz, Del Monte, Haldiram, Kellogg’s, ITC and Marico – have signed up with voluntary commitments to begin reducing salt and sugar in their products by 2020.

“It was an interesting journey to get the industry on board,” Agarwal says. “Though initially there were apprehensions, on the day of signing up for the initiative, they appeared more enthusiastic about it. Some of the enthusiasm might be tempered when they get down to business, but we will take it forward from there. What was particularly heartening was to see the traditional halwais, Haldiram and Bikanervala, get on board. There are major players like Dabur and Parle that are yet to come forward.”

Each company pledge is different. HUL has committed to reducing salt levels to enable intakes of 5g per day. In their tomato ketchup and sauces, for example, this means a 15 to 50 per cent reduction in sodium by 2020 to meet the benchmark of 750mg/100g. They have also pledged to reduce the sugar in their range of children’s frozen desserts to a maximum of 12g per portion in the same time frame.

“Unilever committed long ago to reformulate our products so as to reduce the salt, sugar and fat from our products gradually. The pledge which HUL has signed was just a reiteration of our commitment, which we have already been working on for several years,” a company spokesperson said.

Likewise, Kraft Heinz has pledged to reduce the salt content in its tomato ketchup by 50 per cent in 2025 from current levels and to have nutrition declarations on the front of the packaging on all their products by the end of 2020; Kellogg will reduce the sugar in their ready-to-eat cereals by 10 to 15 per cent and sodium by 10 to 30 per cent by 2020; Nestle will reduce sugar by 6 per cent on average and salt by 10 per cent by 2020, and MTR will reduce salt and sugar by 6 per cent and 5 per cent by 2025. In addition to the nudge from the government, these companies are also reacting to changing consumer preferences and greater awareness of the dangers of eating too much processed food. “Indian breakfast habits and food choices have seen some very interesting shifts over the last decade,” Mohit Anand, managing director, Kellogg’s South Asia, told Mirror.

“Changing lifestyle, travel, experiences, and essentially exposure to a variety of cuisines are significantly impacting changing consumer food choices and attitude towards food. Consumers like to experience ‘food’. Therefore, food is not just sustenance any more. Another obvious big trend is the rise of health and wellness. Therefore, an education initiative like the Eat Right Movement is a multi-stakeholder effort that will empower consumers.”

Industry experts say that several unhealthy products like aerated drinks and vanaspati are being knocked off the shelves, thanks to gradually increasing awareness. “The consumption of vanaspati has been dwindling and production and consumption has gone down since 2012. Trans fatty acid content, which was between 6 to 10 percent in 2012, has been brought down to less than 5 percent in 2017. This is low as per WHO standards, but our commitment is to bring it down to 2 percent, and work is on to improve the interesterification process (a process that creates oil more suitable for deep frying),” explains Dr. KD Yadav, chairman of the technical committee of the Vanaspati Manufacturers Association.

In a bid to reach out to consumers, professional associations like the Nutrition Society of India, Indian Dietetic Association, Association of Food Scientists and Technologists (India), Indian Medical Association, and Indian Federation of Culinary Associations have come together to support the initiative.

“We eat much more salt in our cooking. While the recommended amount is not more than one teaspoon per day for an adult, studies says twice the amount is actually used. We have a whole lot of salty snacks and evening snacking is a persistent habit… most snacks are high in fat and salt,” says Sheela Krishnaswamy, noted dietician and national president, Indian Dietetic Association. “Taste is an acquired thing. It can be changed over time. If we, say, reduce salt gradually and supplement it with increased use of lime, herbs, and garlic that enhances taste and reduces requirement for salt, it can be done.”

Meanwhile Dr. B Sesikeran, President, Nutrition Society of India and former director of National Institute of Nutrition, Indian Council of Medical Research, says that changes in diet need to be complemented by exercise. “The Eat Right Movement attempts to bring about social transformation by bringing in behavioral change. When you tell someone to reduce consumption, compliance is better than asking them to completely avoid it. But along with eating a little less, we also have to tell people to walk and exercise a little more. Once everyone gets into that mode, a year later this campaign can be further intensified,” he says.

The challenge for the food companies is, of course, balancing taste, cost and the relative healthiness of their products. “Stepwise reduction is key,” says Kellogg’s Anand. “We work with our technologies to ensure that the taste is not compromised, as we reduce the salt and sugar levels in a phased way.”

Ankur Bhaumik, chief operating officer of MTR, admits that reformulation of their offerings will create challenges, but he is confident the company will find a way to adhere to their pledge. “There may not be new technology deployed to make these changes, but we are working with stakeholders to explore alternate solutions to help us achieve the target,” he says.

Similarly, Kraft Heinz will attempt to change the salt and sugar components of their tomato sauce while retaining its distinctive flavour. “The reformulated recipe will not compromise on the quality and taste of the product, and will maintain consumer affinity toward the brand,” says Sankalp Potbhare, the company’s Managing Director.

Backed by the Ministry of Health and Family Welfare, FSSAI is hoping to work closely with other ministries such as Information and Broadcasting and Food Processing Industries to create a buzz around the campaign and weave other government initiatives into the larger movement. While the body is banking on publicity through mass media, running ads and Rajkummar Rao’s two-minute video in movie halls and public events, it is set to tie up with the Ayushman Bharat project and hand out toolkits to health workers at the 1.5 lakh health and wellness centers across the country to reach the rural populace.

FSSAI has also proposed that retail chains could nudge consumers to buy healthier food options by ensuring the ingredients and relative healthiness of their products are clearly marked at the points of sale. Of course, there is thin line between educating people about what to eat but leaving it to them to decide and telling people what to eat. The final choice should remain with the individual. If someone wants to eat a salty snack, or a candy bar, he or she should have that option. “Consumer choice should always prevail,” Anand says. “Moreover, there is nothing called ‘good’ or ‘bad’ food. It is about how one consumes those foods as part of the overall balanced diet. All foods have a place in consumers’ eating preferences and can definitely be eaten within a specific portion size.”

The Eat Right Movement has no choice but to play the long game. It will take years for changes in health indicators and lifestyle indicators to reflect, and it will be at least 18 months before most of the companies introduce their new formulations. So the success or failure of the campaign will not be known for years to come. But it is a start and well begun, as they say, is half done.