Nutrition advocates clamor for more stringent restrictions on sugar content in packaged foods, advocating for heightened transparency and accountability in food labeling. The Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN), the nation’s preeminent authority on nutrition, has recently revised its dietary recommendations, advising against the consumption of sugar for children under two years of age.
These updated guidelines, released this week after a hiatus of thirteen years, also propose that individuals over the age of two limit their sugar intake to a mere 5 percent of their daily caloric intake.
In accordance with the World Health Organization’s (WHO) 2015 guidelines on sugar consumption, these recommendations sharply contrast with India’s current policies regarding sugar levels in food products.
Recent scrutiny has focused on Nestlé, the global food conglomerate, for including sugar in its powdered baby food products, such as Cerelac, sold in lower-income countries like India, while excluding it from products in wealthier nations.
This revelation has prompted the Food Safety and Standards Authority of India (FSSAI) to reassess its regulations concerning sugar content in packaged foods.
A joint investigation conducted by Public Eye and the International Baby Food Action Network (IBFAN) last month revealed that all Cerelac baby cereals sold in India, where sales exceeded $250 million in 2022, contain added sugar, averaging nearly 3 grams per serving.
In response, Nestlé India stated that it has reduced added sugars by up to 30 percent, depending on the product variant, in its portfolio of infant cereals (complementary food based on milk cereal).
“We continually evaluate our portfolio and strive to innovate and reformulate our products to further reduce the amount of added sugars without compromising quality, safety, or taste,” the company declared.
Meanwhile, a senior official from FSSAI, speaking to ThePrint, disclosed that in light of the Nestlé controversy, one of its scientific panels is examining the matter and may propose policy adjustments if necessary.
Responding to an inquiry regarding the official stance of the authority, FSSAI shared its regulations on Foods for Infant Nutrition (FSS), stating that lactose and glucose polymers—types of carbohydrates—are preferred for infant nutrition. The regulations also stipulate that sucrose and/or fructose should not be added unless necessary as a carbohydrate source, and the combined amount of these sugars should not exceed 20 percent of the total carbohydrate content.
However, nutrition expert Dr. Arun Gupta, national convener of the nutrition advocacy group Nutrition Advocacy in Public Interest (NAPi), pointed out clear loopholes in India’s existing regulations that are exploited by companies.
He emphasized that the WHO provides specific guidance on a healthy diet for infants and children, stating that from the age of 6 months, breast milk should be supplemented with a variety of safe, nutrient-rich foods, without the addition of salt or sugars.
Despite this, India’s 2020 Food Safety and Standards (Foods for Infant Nutrition) Regulations allow for the addition of sucrose and/or fructose up to 20 percent of total carbohydrates or 13.6 grams of sugar per 100 grams of serving.
Gupta argued that no packaged foods with added sugar should be permitted for infants at all. Moreover, given India’s escalating non-communicable disease crisis, he suggested that products intended for older children and adults should prominently display Front-of-Package Labels (FoPL) indicating whether they are high in fat, sugar, and salt (HFSS). Damage inflicted by sugar
According to the 148-page guidelines by ICMR-NIN, 56.4 percent of the disease burden in India is directly attributable to dietary factors.
Another study conducted by the ICMR, in collaboration with the Madras Diabetes Research Foundation, revealed last year that one in four Indians is diabetic, pre-diabetic, or obese—conditions closely linked to dietary habits and sedentary lifestyles.
Moreover, ample evidence suggests that feeding infants and young children food products containing added sugar increases their risk of early childhood obesity and non-communicable diseases later in life.
Additionally, the American Heart Association recommends that adult women consume no more than 6 teaspoons (approximately 25 grams) and men no more than 9 teaspoons (approximately 38 grams) of added sugar daily.
Despite these guidelines and warnings, many packaged foods, including unexpected ones, contain added sugars such as sucrose and high fructose corn syrup (HFCS).
Dr. Tushar Tayal, lead consultant in the department of internal medicine at CK Birla Hospital, Gurugram, explained that the liver is the primary organ responsible for metabolizing significant amounts of sugar.
“When the liver becomes overloaded, it converts sugar into fat. Some of this fat may accumulate in the liver, leading to fatty liver disease. High sugar consumption is also associated with insulin resistance, metabolic syndrome, obesity, and type 2 diabetes,” he noted.
Furthermore, sugar consumption promotes oxidative stress, inflammation, elevated serum uric acid levels, hypertriglyceridemia, and increased systolic blood pressure. Tayal also highlighted the role of sugar in causing resistance to the hormone leptin.
Leptin is a hormone that signals satiety or hunger to the brain. Leptin resistance, however, results in increased appetite and overeating despite adequate fat stores in the body.
Moreover, refined sugar, being a rapidly digested form of sugar, causes a rapid spike in blood sugar levels, posing significant risks to individuals with diabetes, experts warned.
From a scientific perspective, added sugar in food products poses greater health risks compared to natural sugars, as it contributes excess calories without essential nutrients, explained Seema Gulati, head of the nutrition research group at the Delhi-based non-profit National Diabetes, Obesity, and Cholesterol Foundation.
Gulati added that natural sugars found in fruits and dairy products are accompanied by fiber, vitamins, and minerals, which mitigate some of their negative effects when consumed in moderation.
Meanwhile, the ICMR-NIN guidelines addressed the increasing consumption of highly processed foods, sedentary lifestyles, and limited access to diverse foods in India, all of which contribute to micronutrient deficiencies and rising obesity rates.
The guidelines also raised concerns about the aggressive advertising and marketing of unhealthy foods through various media channels, including social media, influencing dietary preferences among both children and adults and leading to adverse long-term effects.
In light of these issues, Gupta stressed the need for scientific thresholds for sugar, salt, and fat in processed foods if India hopes to combat the growing epidemic of lifestyle diseases.
According to Gulati, there are deficiencies in enforcement or limitations in the scope of food regulation. “It is crucial for regulatory bodies to continually review and strengthen regulations concerning added sugar, salt, trans fat, and other harmful ingredients to safeguard public health. Collaboration among government agencies, health experts, and industry stakeholders is vital to effectively address these issues,” she emphasized.
Meanwhile, Ashim Sanyal, chief operating officer (COO) and secretary at Consumer Voice, a Delhi-based consumer advocacy group, highlighted the regulatory gap in controlling high levels of sugar, salt, and fat in packaged foods, which have become part of the daily diet for many individuals.
“The delay in implementing the FOPL policy is likely due to industry pressure,” he alleged, pointing out that sugar
