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540 asia pac j clin nutr 2015 24 3 540 545 original article the adherence of packaged food products in hyderabad india with nutritional labelling guidelines 1 2 3 4 ...

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               540                                                                                                                         Asia Pac J Clin Nutr 2015;24(3):540-545   
               Original Article  
                
               The adherence of packaged food products in Hyderabad, 
               India with nutritional labelling guidelines 
                
                                                     1,2                                     3                                           4
               Elizabeth K Dunford PhD , Rama K Guggilla MMed , Anenta Ratneswaran MBBS , 
                                                      1,2                                 3                             1,2
               Jacqueline L Webster PhD , Pallab K Maulik PhD , Bruce C Neal PhD  
                
               1
                The George Institute for Global Health, Sydney, Australia 
               2
                The University of Sydney, Sydney, Australia 
               3
                The George Institute for Global Health, Hyderabad, India 
               4
                Imperial College, London, England  
                
                                                                                  
                         Background: India is experiencing a nutrition transition with the consumption of processed foods rapidly in-
                         creasing. Nutrition labels are essential if consumers are to understand the healthiness of these products. The Food 
                         Safety and Standards Authority of India have recently introduced regulation defining national nutrition labelling 
                         requirements and Codex Alimentarius recommends a global standard. Objectives: To quantify the adherence of 
                         the declared nutrients on Indian packaged foods with national and global requirements. Methods: The presence 
                         or absence of data for seven required nutrients was recorded for all food products available for sale. Branches of 
                         three major retail chains and three smaller stores in Hyderabad, India between October and November, 2010 were 
                         surveyed. Results: Data were collected for 4166 packaged products that fell into 14 different food groups. 52% of 
                         products displayed nutrient information on energy, protein, carbohydrate, sugar and total fat, meeting the mini-
                         mum requirements of the Food Safety and Standards Authority of India. Only 27% met the minimum criteria de-
                         fined by Codex which also requires the reporting of saturated fat and sodium. There was significant variation in 
                         compliance for leading brands, country of manufacture and food group (p<0.01 for all). Conclusions: The ma-
                         jority of Indian packaged foods do not meet national and international nutrient labelling guidelines. With the In-
                         dian population likely to consume much more packaged food over coming years full and effective food labelling 
                         will be essential. The failure of Indian legislation to require labelling of sodium and saturated fat may warrant re-
                         view. 
                          
               Key Words: nutritional labelling, processed foods, Codex Alimentarius, India, labelling regulation 
                
                                                                                                                   
                                                                                                                   
               INTRODUCTION                                                        on product packaging) in India published in 2009 by the 
               Chronic diseases are the leading cause of premature death           Ministry of Health identified food labelling as “one of the 
               and disability in the world and cause the greatest propor-          important population-based approaches that can help con-
               tion of disease burden in all but the least developed coun-         sumers make healthy food choices by providing the nec-
                     1                                                                                                                     8
               tries.   These  diseases  are  substantively  attributable  to      essary information about the food on the pack”.  This 
               poor diet, with over-nutrition a major cause of diet-related        assessment included one small market survey in Hydera-
                          1,2
               ill  health.    Many  low  and  middle  income  countries           bad in 2009 where data were collected for 815 products. 
               around the world are now experiencing a “nutrition tran-            This study looked mainly at compliance with local label-
               sition”, where the consumption of processed foods high in           ling standards but did not explore the types of nutrients 
               energy  density,  saturated  fat,  sugar  and  salt  is  increas-   that were displayed on products. The kinds of nutrition 
                   3-5
               ing.                                                                information made available for consumers on packaged 
                  Traditionally,  the  Indian  population  has  consumed  a        foods is important, particularly as research has shown that 
               diet based upon fruits, vegetables and unprocessed cere-            37% of Indians always check the nutritional information 
                   6
               als.   National  Nutrition  Surveys  done  over  the  past  20      when buying packaged food and that only 5% Indians 
                                                                                                                   9
               years show that consumption patterns are now changing,              never check nutrition labels.  Also, with only 59% Indi- 
                                                                    7
               particularly in high- and middle-income groups.  Increas-
                                                                                    
               es in per capita disposable income, alterations to lifestyle 
                                                                                   Corresponding  Author:  Dr  Elizabeth  Dunford,  the  George 
               and changes in the food environment are driving consum-
                                                                                   Institute for Global Health King George V Building Missenden 
                                                           6
               ers  towards  highly  processed  products.   With  this  shift 
                                                                                   Rd Camperdown NSW, 2050 Australia. 
               from  the  preparation  and  consumption  of  whole  foods 
                                                                                   Tel: + 61 2 8507 2529; Fax: + 61 2 9993 4502 
               comes a need for food labelling such that the content of 
                                                                                   Email: edunford@georgeinstitute.org.au 
               processed foods can be relayed to consumers. 
                                                                                   Manuscript received 08 July 2014. Initial review completed and 
                    The latest assessment on the status of nutrition label-        accepted 30 September 2014. 
               ling (defined in this paper as the declaration of nutrients         doi: 10.6133/apjcn.2015.24.3.08 
                                                                                   Labelling of Indian processed foods                                                               541                                                             
               ans understanding the food labels that they read, it is im-          presence of nutritional information per 100 g (or per 100 
               portant to ensure that all food manufacturers are display-           mL for fluids), manufacturer name and country of manu-
               ing  sufficient  and  comparable  nutrition  information  on         facture were the minimum data sought. 
                               9
               their products.                                                       
                  Prior to  2006,  the information requirement  for  pack-          Data analysis 
               aged food products in India was governed by the 1954                 The number and percentage of products displaying infor-
               Prevention of Food Adulteration Act which provided for               mation on the package for energy, protein, carbohydrate, 
               the provision of basic data such as product name and ex-             sugar, total fat, saturated fat and sodium were calculated 
               piry  date,  but  not  nutritional  information.  Labelling re-      for each food group. The percentage of products display-
               quirements  are  now  the  remit  of  the  Food  Safety  and         ing  the  minimum  nutrient  information  requirements  by 
               Standards Authority of India which in 2011 introduced                the Food Safety and Standards Authority of India (energy, 
               new packaging and labelling regulations that require core            protein,  carbohydrate,  sugars  and  total  fat)  and  Codex 
                                                       10
               information  on  nutritional  content.   In  parallel,  Codex        Alimentarius (energy, protein, carbohydrate, sugars, total 
               Alimentarius, the international  body  governing  food  la-          fat, saturated fat and sodium) were calculated overall, for 
               belling, established by the Food and Agriculture Organi-             each food group, for products manufactured in India ver-
               zation and the World Health Organization in 1963, has                sus  imported  products,  and  for  products  marketed  by 
                                                                       11
               also  revised  its  guidelines  on  nutrition  labelling.   The      leading  brands.  Leading  brands  were  defined  as  those 
               objective of this study was to define the extent to which            which had more than 50 products in the database. Pear-
               packaged food products available for purchase in a sam-              son’s chi-squared tests were used to examine the propor-
               ple of Indian stores in the State of Andhra Pradesh met              tions  of  products  complying  with  labelling  criteria  be-
               these guidelines prior to the 2011 legislation coming into           tween  groups.  All  statistical  analyses  were  done  using 
               effect.                                                              IBM SPSS Statistics Version 19 and a p value of <0.05 
                                                                                    was considered unlikely to have arisen by chance alone. 
               METHODS                                                               
               This study comprised a survey of processed foods for sale            RESULTS 
               at  selected  retail  outlets  in  Hyderabad,  India  with  data     Data were collected for 4166 products in 14 food catego-
               collection done over a two month period between October              ries. Seventy five percent of products were manufactured 
               and November 2010.                                                   in  India  with the remaining products imported from 21 
                                                                                    other  countries.  Packaged  fruit  and  vegetable  products 
               Retail outlets surveyed                                              were  the  category  with  the  largest  number  of  products 
               The survey included six stores in urban areas. The stores            comprising 19% of the total, followed by cereal and cere-
               were three large chain retail outlets in Jubilee Hills fre-          al  products  with  12%.  Fish  and  fish  products  were  the 
               quented primarily by wealthier customers, and three small            least in number making up just 1% of the total. Twelve 
               individually managed stores in two localities adjacent to            brands had  more than 50  products in the  database  and 
               Jubilee Hills where less affluent consumers buy their food           together the leading brands covered 1278 different food 
               products. The stores were purposefully selected to ensure            items. 
               that a broad range of packaged foods representative of all            
               packaged products for sale in Hyderabad was included.                Overall compliance with labelling requirements 
               Permission was obtained from each store.                             Fifty  two  per  cent  of  products  displayed  the  minimum 
                                                                                    nutritional information required by the 2011 Indian label-
               Data collection                                                      ling legislation (energy, protein, carbohydrate, sugar and 
               Data collection was done by three trained persons who                total fat) but only 27% complied with the minimum rec-
               visited the stores and recorded the label data onto a stand-         ommendations of Codex, which suggests the additional 
                                            12
               ard  data  collection  sheet.   All  packaged  food  products        reporting  of  saturated  fat  and  sodium (Table  1).  Sugar, 
               that were available for sale in each store during the period         saturated fat and sodium were each reported on about half 
               of data collection were recorded. Where exactly the same             of products while the other data were reported for about 
               food  was  presented  in  different  packaging  or  different        three quarters (Table 1). 
               serving sizes or was present in multiple stores, only one             
               set of information was collected unless the product was              Completeness of labelling by brand, food category and 
               marketed as a different brand. The data entry process was            country of manufacturer 
               verified by taking a random sample of 10% of entries and             The completeness of food labelling varied markedly 
               comparing  the  information  on  presence  or  absence  of           between brands and food categories for both Food Safety 
               nutritional labels in the database against the original data         and  Standards  Authority  of  India  and  Codex 
               source  in-store.  In  no  case  was  there an  error  whereby       recommendations (p<0.01 for all). There were two brands 
               information about a nutrient was recorded incorrectly as             with complete adherence to local requirements (Britannia 
               being present or absent on the label.                                and PepsiCo India with 109 products in total) but none 
                                                                                    with more than 70% of products meeting Codex 
               Food categories and variables collected                              recommendations (Figure 1). Convenience foods were the 
               The food categories used here were based on those devel-             category most adherent to both local (80%) and Codex 
                                                                12
               oped by the Global Food Monitoring Group.  According-                (46%) recommendations whilst edible oils, at the other 
               ly, foods were categorized into 14 food groups. For each             end of the spectrum, were almost completely non-
               food item, the brand name, product name, serving size,               adherent (Figure 2). Imported products were more 
               542                         EK Dunford, RK Guggilla, A Ratneswaran, JL Webster, PK Maulik and BC Neal 
                 Table 1. Proportion of Indian and imported products meeting Food Safety and Standards Authority of India and 
                 Codex guidance for nutrition labelling 
                  
                                                                                                                            *
                                            Indian products (%)     Imported products (%)       All products (%)     p value  (Indian vs imported) 
                 Energy                              73                       86                       76                       <0.01 
                 Protein                             73                       85                       76                       <0.01 
                 Carbohydrate                        73                       86                       77                       <0.01 
                 Sugar                               49                       70                       54                       <0.01 
                 Total fat                           72                       85                       75                       <0.01 
                 Meet Food Safety and                47                       68                       52                       <0.01 
                 Standards Authority of 
                 India 
                 Saturated fat                       42                       58                       46                       <0.01 
                 Sodium                              31                       69                       41                       <0.01 
                 Meet Codex                          19                       50                       27                       <0.01 
                  
                 *
                  p values for comparisons obtained using chi-squared tests. 
                  
                  
                                                                                                                                  
                  
                 Figure 1. Percentages of products meeting Food Safety and Standards Authority of India and Codex requirements for nutrition labelling 
                 overall and by leading brands 
                  
               adherent by both measures than locally manufactured                  burden of premature death and disability this is something 
                                                                                                                     14
               foods with 52% vs 47% (p<0.01) and 27% vs 18%                        that the country can ill afford.  India is not alone in the 
                (p<0.01) meeting Food Safety and Standards Authority                lack  of  nutrition  information  being  displayed  on  food 
               of India and Codex recommendations respectively (Table               packages, but is “on par” with a number of other devel-
                                                                                                                      8
               1).                                                                  oped and developing countries.  Previous Indian research 
                  Large numbers of packaged food products available in              has indicated that consumers have difficulty interpreting 
                                                                                                                             8
               Indian  stores  fail  to  display  the  nutritional  information     the nutritional information on foods,  and it is therefore 
               that  consumers require  to  make informed choices. This             important  to  ensure  that  all  food  manufacturers  are 
               represents a major public health issue as consumers are              displaying     sufficient    and     comparable      nutrition 
               eating more and more processed foods without access to               information     on   their   products,    particularly    with 
               basic information about their healthiness. Since processed           international research showing that nutrition labels are the 
               foods generally have higher levels of energy, saturated fat,         key source consumers turn to when trying to evaluate a 
                                                                                                           8
               sugar and salt than their unprocessed counterparts, this is          product’s healthiness.  
               likely to result in serious adverse health outcomes for the            It  is  encouraging, therefore, that the Food Safety and 
                            13
               population.  With India already suffering an enormous                Standards Authority of India has now put in place regula-
                                                                                  Labelling of Indian processed foods                                                               543                                                             
                                                                                                                                    
                  
                 Figure 2. Percentages of products meeting Food Safety and Standards Authority of India and Codex requirements requirements for 
                 nutrition labelling overall and by food group 
                  
               tion defining minimum requirements for the labelling of                This paper represents an important insight into food la-
                                                             10
               the nutritional content of packaged foods.  However, the            belling  practices  in  local  and  imported  packaged  food 
               absence of sodium and saturated fat levels from the cur-            products in India. Strengths of this study are its large size, 
               rent requirement warrants review. The routine provision             the systematic evaluation of all products for sale in the 
               of sodium data on packaged food products will be vital              stores included and the comparison of compliance against 
               for the effective implementation of salt reduction efforts          both national and international guidance. The restriction 
               in India, as it will be elsewhere in the world. Likewise,           of the survey to Hyderabad was a limitation and it is un-
               the  absence  of  saturated  fat  from  the  Food  Safety  and      likely that the products included in the survey are truly 
               Standards Authority of India requirements may also be an            representative of all products available for sale in India.  
               oversight that needs correction. Saturated fats are impli-          It is also possible that levels of compliance with labelling 
               cated particularly strongly in the causation of dyslipidae-         regulation may vary from other parts of Andhra Pradesh 
                                            15
               mia and vascular disease.  Another issue relating to the            and between the other States and Territories of the coun-
               enforcement of the Indian food labelling regulation is that         try.  However, many of the manufacturers with included 
               food  safety  regulators  lack  knowledge  of  the  existing        products  supply  nationally  and  so  it  is  likely  that  the 
               food labelling regulations because updates  through gov-            products included in this study would be available in oth-
                                                                16
               ernment channels have not been forthcoming.                         er parts of India. Local data suggest that packaged foods 
                  Periodic follow-up surveys to assess the compliance of           constitute a similar proportion of the food supply across 
                                                                                                                17
               national and international corporations with this initiative        multiple regions of India.  We also note that this study 
               of the Food Safety and Standards Authority of India will            has focused only on the presence or absence of nutrient 
               be an important aspect for the Indian government to take            labels and does not address other aspects of labelling de-
               leadership in. It is also clear from the differences between        fined under Food Safety and Standards Authority of India 
               the compliance achieved for different food categories and           and Codex requirements such as the date of manufacture, 
               different food companies that better adherence to label-            the  ingredients  statement,  declared  nutrient  levels  and 
               ling requirements can be achieved if the drivers are right.         contact information for the manufacturer. 
               A careful  examination  of  the  corporate  policies  behind           The achievement of good food labelling in India will 
               brands like  Britannia  and  PepsiCo  India  might  help  to        be an important part of the country’s efforts to address the 
               identify the means by which compliance can be enhanced.             burgeoning  non-communicable  disease  burden,  and 
               Likewise,  the  systematically  greater  proportions  of  im-       government leadership in this area will be vital. This pa-
               ported compared to local products that are compliant with           per has identified important problems with how nutrients 
               recommendations suggest that multinational corporations             are labeled on food packages in India. The results of this 
               might be able to provide insight into mechanisms for im-            paper will be useful in informing government on the in-
               proving  product  labelling  in  India.  For  example,  many        dustry’s  adherence  to  labelling  of  required  nutrients  in 
               multinational  companies  that  import  products  to  India         India,  and  provide  a  baseline  from  which  future  im-
               will also operate in countries that have legislation requir-        provements  in  Indian  food  labelling  can  be  monitored. 
               ing compliance with Codex, and it would be straightfor-             The enforcement of effective food labelling regulations 
               ward for these companies to provide full nutrition labels           will  both  help  consumers  to  make  better  choices  and 
               for the foods they market in India.                                 facilitate the monitoring of industry compliance with the 
                                                                                   program.  
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...Asia pac j clin nutr original article the adherence of packaged food products in hyderabad india with nutritional labelling guidelines elizabeth k dunford phd rama guggilla mmed anenta ratneswaran mbbs jacqueline l webster pallab maulik bruce c neal george institute for global health sydney australia university imperial college london england background is experiencing a nutrition transition consumption processed foods rapidly creasing labels are essential if consumers to understand healthiness these safety and standards authority have recently introduced regulation defining national requirements codex alimentarius recommends standard objectives quantify declared nutrients on indian methods presence or absence data seven required was recorded all available sale branches three major retail chains smaller stores between october november were surveyed results collected that fell into different groups displayed nutrient information energy protein carbohydrate sugar total fat meeting mini m...

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