Journal of Family Medicine and Primary Care

EDITORIAL
Year
: 2020  |  Volume : 9  |  Issue : 5  |  Page : 2158--2160

Banning unhealthy foods in school premises in India: Its implications and future recommendations


Sudip Bhattacharya1, Raman Kumar2,  
1 Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
2 President, Academy of Family Physicians of India, New Delhi, India

Correspondence Address:
Dr. Sudip Bhattacharya
Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun - 248 140, Uttarakhand
India

Abstract

Globally, the consumer food environment is often shaped by market interests rather than emphasizing nutritional quantity and quality. In low- income countries like India, such unhealthy food products are becoming increasingly available, accessible, and affordable to the common people, especially the school going children, which is a major concern to us. Despite huge amount of evidence, public health institutions are not addressing this pressing issue adequately. It could be due to the contradictory nature of the policies. Now it will be interesting to observe the implementation of “Eat Right” campaign, new FSSAI guidelines and good food tax policy, which should take care of India's’ overall growth in terms of health and economy, both.



How to cite this article:
Bhattacharya S, Kumar R. Banning unhealthy foods in school premises in India: Its implications and future recommendations.J Family Med Prim Care 2020;9:2158-2160


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Bhattacharya S, Kumar R. Banning unhealthy foods in school premises in India: Its implications and future recommendations. J Family Med Prim Care [serial online] 2020 [cited 2020 Jul 15 ];9:2158-2160
Available from: http://www.jfmpc.com/text.asp?2020/9/5/2158/285130


Full Text



 The Problem



Globally, the consumer food environment is often shaped by market interests rather than emphasizing nutritional quantity and quality. In low- and middle-income countries like India, such unhealthy food products are becoming increasingly available, accessible, and affordable to the common people, which is a major concern for the population health and well-being. A study conducted in an urban slum area of the northern part of India by Bhattacharya et al. revealed that poor slum population is replacing their meals with local burgers, which is unhygienic as well as unhealthy. This is because the local burger is much cheaper than their traditional foods (roti and sabji).[1],[2],[3],[4] Therefore, cheaper foods are impacting dietary practices, patterns of food consumption, and associated health outcomes.

Currently, the market forces are compelling the individuals to influence their current food behavior by aggressive promotion and publicity of unhealthy foods and drinks in different settings (e.g., market, school canteen, etc.) making unhealthy foods readily available and accessible whereas healthy food choices are becoming limited to the common people. Such market forces are primarily targeting the children and youth with the help of mass media advertising, which influences their purchasing patterns and eating behaviors. This crisis often becomes complex in nature where consumers start eating traditional Indian foods with junk foods without understanding the health consequences of such dietary practices (e.g., drinking soft drinks with “samosa”). An unhealthy diet complements the sedentary behavior of a majority of the population and contributes to the high burden of non-communicable diseases (NCDs) including childhood obesity, diabetes, and hypertension.[5],[6]

This problem is critical for school-going children who are less likely to make informed choices about dietary practices and consume foods that are readily available near the schools. Global evidence suggests that the availability of fast food in schools has attributed an epidemic known as childhood obesity epidemic, which is a major concern in the era of the high prevalence of NCDs.

Research suggests that in the USA, nearly 33% of all children and young adults are overweight or obese. This challenge is also prevalent in India; the prevalence of childhood obesity and overweight is 19.3 percent.[7] The ongoing obesity epidemic in India necessitates a critical analysis of obesity prevention strategies in the global context.

In the USA, considerable attention has been given to school policies to prevent this new epidemic (childhood obesity). Especially, the easy availability of fast foods and cold drinks on school premises.[8]

Available research suggests that fast foods are unhealthy as it contains a higher amount of fat and sugar compared with homemade foods.[8]

 The Moot Question



Now our fundamental question is, despite the huge amount of evidence why public health institutions are not acting on this issue or acting slowly? It could be due to the contradictory nature of policies which are replacing fast foods/unhealthy foods to healthier foods, such as high tax or complete ban on fast foods.

Another reason may be, nations economic growth is sometimes in conflict with a healthy food environment.

However, in the long term this kind of myopic vision of the policymakers could lead to significant negative socio-economic consequences, as an example, presently obesity crisis is costing South Africa $48.8 billion per year.[9]

It is estimated that the budget is allotted for a 20-second advertisement of the cold drink is much greater than a yearly budget to run a health program of a country.

However, due to public health advocacy, we have witnessed that tax on tobacco has been implemented over 188 countries, alcohol tax in over 160 countries, and taxes on sugary drinks have been implemented in 39 countries. Indeed, this is an example of legislative and public health success. There are many global recommendations are available backed with evidence to tackle this issue, which ranges from implementing tax to legislation, and surely evidence plays an important role to minimize the harmful effects of commercialization.[9]

 Role of Formal Education



Education about consuming healthy foods among students from the school level helps children as accountable citizens for society. Eating unhealthy food has negative consequences on child endurance, all families would like that their children should eat good food items in their school premises also. To achieve this goal we not only have to take appropriate steps (psychologically and attitudinally) from the very beginning but also undertake a legislative approach for banning junk foods on the school premises. Otherwise, it will be very difficult to counter the influence of the fast-food industry.

Various aspects (knowledge, attitude, and practice) of our life including health are developed in childhood.[10] So, schools can also play a very important role in developing the right knowledge and attitude about food behaviors among the school-going children, for this we need them to provide a fast-food free food environment.

 Food Regulations in India: ‘The Eat Right Movement'



Recently, the Food Safety and Standards Authority of India (FSSAI), has decided to ban all kinds of junk foods on the school premises from December 2019. To curb unhealthy food practices by the school children, FSSAI has also framed Food Safety and Standards regulations 2019.

FSSAI comes out with ‘The Eat Right Movement’ and new food safety guidelines, which emphasizes on “banning the sale of pre-packaged foods, which are referred to as foods high in fat, salt, and sugar to school children in school canteens/mess premises/hostel kitchens or within 50 meters of the school campus.”

The guideline prohibits junk food manufacturers from any kind of promotion campaign in the school events.[11]

 The Way Forward



Indeed, this a welcome step. Eventually, the political economy should have a greater influence on the policy process. Now it will be interesting to observe the implementation of this ‘The Eat Right Movement’ from a public health viewpoint. As we know that it can affect the economy negatively, due to loss of revenue as well as potential job losses from the junk food industry. Now it is high time for us to design and implement a good food tax policy that should take care of India's’ overall economic, social, and political context and prevent us from both the obesity epidemic and economic slowdown.

References

1Beaglehole R, Yach D. Globalisation and the prevention and control of non-communicable disease: The neglected chronic diseases of adults. Lancet 2003;362:903-8.
2Bhattacharya S, Singh A. Fixing accountabilities and finding solutions to tackle acute (communicable) diseases viewed as collateral damage due to errors of omission and commission in primary care. J Fam Med Primary Care 2019;8:784-7.
3Bhattacharya S, Thakur JS, Singh A. Knowledge attitude, and practice regarding dietary salt intake among urban slum population of North India. J Family Med Prim Care 2018;7:526-30.
4Riley LW, Ko AI, Unger A, Reis MG. Slum health: Diseases of neglected populations [Internet]. BMC Int Health Hum Rights 2007;7:2. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829399/. [Last cited on 2019 Jan 16].
5Angkurawaranon C, Jiraporncharoen W, Chenthanakij B, Doyle P, Nitsch D. Urbanization and non-communicable disease in Southeast Asia: A review of current evidence. Public Health 2014;128:886-95.
6Thakur. Public Health Approaches to Non-Communicable Diseases. International ed. S. L.: Wolters Kluwer; 2015. p. 448.
7Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight and obesity in India: A systematic review. Indian J Med Res 2016;143:160-74.
8Datar A, Nicosia N. Junk food in schools and childhood obesity. J Policy Anal Manage 2012;31:312-37.
9'India should beware of being colonised again – this time in the form of the food and beverage industry’ [Internet]. Times of India Blog 2019. Available from: https://timesofindia.indiatimes.com/blogs/the-interviews-blog/india-should-beware-of-being-colonised-again-this-time-in-the-form-of-the-food-and-beverage-industry/. [Last cited on 2019 Sep 13].
10Bhattacharya S, Singh A, Prakash K. Does stream of education affect the knowledge and attitude regarding breastfeeding among adolescent students? Indian J Comm Health 2016;28:337-43.
11Ban proposed on sale, ads of junk food in school - The Hindu [Internet]. Available from: https://www.thehindu.com/sci-tech/health/ban-proposed- on-sale-ads-of-junk-food-in-school/article29891500.ece. [Last cited on 2019 Nov 09].