Nutritionists and doctors across the country are calling for a systemic approach to manage the rapidly rising prevalence of non-communicable diseases (NCDs) now more than ever, with particular emphasis on policy actions to establish science-based limits on saturated fats, salt, sugar (FSS) in packaged and ultra-processed food and beverages. With digestive disorders gradually rising in number, Front-of-Package Labelling (FoPL) is the apt tool that can aid consumers in improving their diets.
According to a recent report released by the Associated Chambers of Commerce and Industry of India (ASSOCHAM) on the prevalence of non-communicable diseases (NCDs) in India, digestive disease has been identified as one of the leading NCDs in the country, along with hypertension and diabetes.
The findings have revealed that the overall prevalence of all digestive diseases such as Gastroesophageal Reflux Disease (GERD), constipation, dyspepsia, gastritis, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) etc. among the population suffering from an NCD is 24.3 per cent were three common digestive diseases including constipation (8.2 per cent), dyspepsia or indigestion (5.4 per cent) and gastritis (5.6 per cent) together account 19.2 per cent prevalence of digestive disorders in India.
Further, it has been observed that the prevalence of digestive diseases is quite high in age groups 18- 25 years and 26-35 years in comparison to their average prevalence. The overall prevalence of all digestive diseases among the population suffering from an NCD is 24.3 per cent.
Sharing more details about the survey, Vineet Agarwal, President, ASSOCHAM, New Delhi says, “Digestive diseases were found to be the second most prevalent NCD among the respondents at 3.2 per cent while cancer was the least prevalent NCD at a mere 0.1 per cent. The high intake of dairy products, fats and meat affect digestive disorders the most, increasing their chances by 63 per cent. Low intake of fruits and vegetables increase the chances by 36 per cent and high intake of junk and fried foods increase the chances of developing digestive disorders by 28 per cent. In addition, high-stress levels increase the chances of developing digestive disorders by 25 per cent.”
On the other hand, a recent survey conducted by Kolkata-based FMCG firm ITC revealed that 56 per cent of Indian families have reported digestive health problems. Indigestion, acidity, and gas were found to be the top 3 digestive health issues as more than 50 per cent of respondents reported suffering from at least one of these three. The survey also revealed that more than 50 per cent believe that digestive health problems adversely affect energy levels and weight management, and the experience results in abnormal bowel movement amongst others.
Healing it naturally
It has been observed that many people do not seek treatment for digestive diseases and believe that symptoms can be resolved easily without medical supervision. In fact, the ITC survey has revealed that more than 70 per cent resort to home remedies, along with improving daily eating habits, as a solution to tackle digestive health problems.
The most common remedies involve the use of natural ingredients like jeera, ajwain, ginger etc. to get relief from digestive problems. Although a large number of modern and alternative medicine-based products are available in the market to treat digestive health-related problems, pharmaceutical companies are now preferring to address this concern by using natural ingredients.
For instance, New Delhi-based Mankind Pharma is streamlining its marketing strategy through a digital route for its natural antacid brand Gas-O-Fast, in order to reach a larger number of consumers.
“In recent times, there is a significant growth in e-commerce that is likely to augment the demand for antacids through online retailing. Deskbound jobs in the work-from-home culture, poor quality of sleep and irregular dietary habits, are resulting in an increase in acidity level of the stomach and leading to gastroesophageal reflux sickness. As a result, people are turning towards natural ingredients such as jeera, ajwain, saunf, pudina etc. for relief. In the next three years we are targeting to grab maximum market share in the antacid category by launching new ayurvedic flavours”, says Joy Chatterjee, General Manager, Sales & Marketing, Mankind Pharma, New Delhi.
On the other hand, Chennai-based Olene Life Sciences has developed a novel patented formulation using ginger for reducing a broad range of functional dyspepsia-related symptoms in chronic sufferers. The product Ginfort, which is being currently marketed by US-based Dolcas Biotech, consists of highly concentrated gingeroid extract in powder form.
“Ginger has been highly prized in ancient Chinese and Indian traditions not only for its culinary properties but as a powerful medicinal, especially as a prominent reliever of stomach distress. The underground rhizome of the ginger plant holds the bulk of its beneficial properties, most of which are attributed to the presence of volatile oils”, says Vivek Anand Parachur, Chief Executive Officer, Olene Life Sciences, Chennai.
Calling for stringent regulations
By enriching one’s diet with fibre-rich foods such as cereals, fruits, wheat-based products, leafy vegetables, etc. and resorting to ayurvedic solutions can ease digestion, but the need of the hour is to implement simple measures such as front-of-package labels (FOPL) that can make a paradigm shift in the food consumption pattern of the country and as a result, avert an impending NCD crisis of digestive health.
Insertion of simplified nutrition information on the front of food packages is a cost-effective strategy to guide consumers to make healthier choices and discourage them from consuming foods that are high in salt, sugar, fat, the critical nutrients causing a rise in digestive health problems, diabetes and hypertension.
“A strong ‘Nutrition Profile Model (NPM)’ is required to guide consumption of processed and ultra-processed food in India towards eradicating the NCD burden. NPM is a scientific method for categorising food and beverage items according to their nutritional composition and is developed to moderate consumption of sodium, saturated fat and added sugar. Based on the “cut off” established by the NPM, the front-of-pack label informs consumers whether a product contains excessive sugar, sodium and saturated fat”, shares Keshav Desiraju, Chairman, Nutrition Advocacy in Public Interest – India (NAPI), New Delhi.
The Food Safety and Standards Authority of India (FSSAI) is working aggressively to bring down the high salt, sugar and fat content on both the demand and supply side. On the demand side, the ‘Eat Right India’ movement is focusing on empowering citizens to make the right food choices, while on the supply side, it is nudging the food industry to reformulate their products, provide better nutritional information to consumers and make investments in healthy food.
At present, the industry is playing an important role in eliminating harmful chemicals from oils, fats, and food by adopting the World Health Organisation recommended threshold of less than 2 per cent trans fats (TFA) by 2023.
On this note, Biprabuddha Chatterjee, Head – R&D, Adani Wilmar, Ahmedabad says, “Challenge lies in converting foods that require a solid fat ingredient such as all bakery and confectionery products. We supply these complicated fats to major MNCs across the world such as Nestle and Cadbury. To remain at par with the best standards of food safety, we had to achieve the target of TFA elimination much earlier.”
Stressing on the importance of educating consumers, Manjit Singh Gill, Corporate Chef, ITC Hotels, Gurugram says, “Vanaspati is never a favourite for chefs, it does not enhance the taste, flavour or anything else. In ITC, we had already stopped using it in our foods. To eliminate it completely from our food, it is also important for all food producers to transparently declare what quantity of the ingredient is present in each product. That has to be made mandatory.”
FSSAI has currently established a Working Group that is finalising the recommendations for FOPL, which would then be referred to the scientific committee for endorsement and food authority for approval as per the due procedure.
In recent years, FoPLs are increasingly being implemented by governments internationally to support consumers to make healthier food choices. Already Chile, Israel, Peru, Mexico, Brazil and Uruguay have adopted a warning label system. As more and more countries adopt mandatory and strong FOPLs, India can join the growing list of countries that are realising the potential of urgent policy steps to safeguard the lives of people. FOPL works best when it is made mandatory, applies to all packaged products, the label is interpretative, simplistic, and readily visible, guided by a scientific nutrient profile model.
Dr Manbeena Chawla