Dying for chips and sodas: India must follow Brazil’s example in advising citizens how to eat, not what to eat

By Raj Patel and Amit Srivastava

Last week, a landmark decision in the Delhi high court moved India higher among the ranks of Brics. In Brazil, Russia, India, China and South Africa the economy isn’t the only thing growing. So is the risk of dying from heart disease, diabetes, respiratory disease or cancer. The irony of these diseases is that while they’re hard to treat, they’re easy to prevent. In its decision, the court demanded the restriction of junk food available in and around India’s schools.

This is a terrific first step in reducing the consumption of foods that are likely to seriously harm Indian children’s health in the future. But India’s nutritionists and paediatricians have called for more aggressive responses to tackle the diabetes epidemic. Mustering the will to do what’s necessary can be hard, especially given an increasingly powerful food industry.

Good science can help, both by informing good policy and generating the good will necessary to create it. Consider, for instance, the science behind Brazil’s recent advances in public health.

Usually, the way that science appears to consumers is when it’s regurgitated in governmental dietary guidelines. India’s guidelines contain sensible, if dyspeptic, advice which comes with the ring of benevolent dictatorship about it: Consume healthy food! Don’t consume unhealthy food! Breastfeed!

The Brazilian government is no less concerned about its citizens, but the approach is rather different. Rather than advise what to eat, the just released national official dietary guidelines encourage citizen to think about how to eat. They seem to trust their citizens’ intelligence a little more.

For example: Indian guidelines encourage a variety of foods. Brazilian ones encourage eating in company. Indian guidelines warn against too much salt. Brazilian guidelines warn against any ready-to-consume ‘ultra-processed food’. This last idea matters a great deal in India. The Delhi high court wrestled with defining ‘junk food’, following the PIL by the Delhi-based Uday Foundation to ban such food in schools.

The food industry claimed that there is no such thing as junk food. This came as a surprise both to anyone with basic common sense, but also to the Brazilian government, which has adopted ideas based on the nutritional science of world-class epidemiologists like Carlos Monteiro at the University of São Paulo.

Monteiro came across the idea of ‘ultra-processed food’ while he was trying to solve a mystery. Brazilians were dying of diseases associated with diet, the kinds of illnesses that are killing and maiming millions of Indians. What was strange, though, was the reason.

Nutritional science warned that eating more salt, fat and sugar is bad. But Brazilians’ increase in waistlines, morbidity and mortality couldn’t be explained by a massive increase in eating these things. What changed was the way salt, fat and sugar was entering Brazilians’ stomachs. Monteiro discovered that extra salt, fat and sugar wasn’t coming from culinary preparations or even from simple, ancient processed foods like breads and cheeses, but through combination in ‘ultra-processed foods’.

Of course, just like their counterparts in India, Brazil’s rural poor need to process their food to prevent spoilage and waste. Traditional food processing is vital for people to be able to feed themselves, and Brazil’s guidelines are geared toward supporting small-scale farmers. Dried, fermented, pasteurised, cleaned foods weren’t what Brazilians were eating more of, though.

The modern food industry has invented new technologies like hydrolysing, hydrogenation, refining and extrusion which produce new kinds of food. When you take old food products like oils, sugar and salt, and add them to these new food products – hydrogenated oils, protein isolates, starches and laboratory stores’ of novel additives – you get ultra-processed food: Ready to heat and eat, designed to have a long shelf life, be habit-forming, made to be consumed anywhere.

Think instant noodles, packaged snacks and soft drinks – the type of food that threatens to replace natural and minimally processed foods like sabzi, dal and roti often cooked at homes across India.

The rise in marketing, sales and consumption of these foods, argued Monteiro and his colleagues in a series of seminal peer-reviewed articles, is what is driving not only the rise of non-communicable disease like diabetes and heart disease in Brazil, but internationally. This is why Brazil’s guidelines don’t advise citizens what to eat, but to think about the extent to which what they’re eating is processed. And to make natural and minimally processed food the basis of their diet.

We know that continued consumption of ultra-processed foods is likely to be harmful, that children are ill-equipped to judge how much to consume, and that tastes are created early in childhood. With all this in mind, another Brazilian agency has encouraged action surpassing that of the Delhi high court. Brazil’s National Council for Defence of Children and Adolescents Rights is proposing the banning of marketing of all products to children. The Brazilian dietary guidelines ask that people be wary and critical of all forms of food marketing and advertising.

The health effects of ultra-processed food are easy to predict. And now that a nation of 200 million people is developing effective policies around the idea of ‘ultra-processed food’, the Indian government should too. It’s an idea that’s far from junk.

(Raj Patel is a Professor of Public Affairs at University of Texas, Austin. Amit Srivastava works with the India Resource Center on corporate accountability)

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