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As the American diet is being exported to India in the form of increased consumption of meat, fast food and brand-name beverages, is India nurturing a new public health crisis, asks MICHELLE MASCARENHAS.
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JUST a few years ago, researchers were astonished to find that the number of people suffering from hunger or malnutrition worldwide was equivalent to the number of overweight or obese people — about one billion each. Last week, the London-based International Obesity Task Force revised the estimate of overweight people to 1.7 billion.
The problem of obesity in the United States is known throughout the world. But as the American diet is being exported to India in the form of increased consumption of meat, western fast food, and brand-name sodas, is India incubating a new public health crisis? And with a population more than 3.5 times that of the United States, and a poverty rate even higher, can India afford it? Will India be forced to choose between eradicating hunger and treating those who are overweight? The indicators paint a grim picture.
The realities of hunger and poverty in many developing countries have led to an association of being "plump" with being wealthy. But increasingly, the developing world and low-income households worldwide are at greatest risk of obesity, overweight and diet-related diseases. In some households, one family member may suffer from hunger and malnutrition while another suffers from weight or diet-related problems. Public health workers called onto address these issues are baffled as to what to prescribe.
Is America exporting a diet that causes people to go from hunger to obesity, skipping over an optimal healthy diet? India presents a case study of this paradox, the causes, and policy options to prevent a new public health crisis.
In 2000, the economic cost of obesity in the U.S. was over $115 billion. Many families endure daily worries over diet-related diseases such as diabetes, heart disease and high blood pressure. People of South Asian descent have been found to suffer even higher rates of cardiovascular disease than people of European descent, causing some researchers to speculate that the shift to a western diet may have even more serious consequences among South Asians worldwide. This is due in part to the finding that South Asians tend to carry more of their weight around the midsection, putting added strain on the heart and cardiovascular systems.
Having tapped much of the market in the U.S. and Europe, multinational food companies, from Tyson Chicken to McDonalds and Coca-Cola, have shifted their attention to the developing world over the past decade. In a recent report to the World Health Organisation, food policy analyst Dr. Corinna Hawkes reveals the marketing practices that fast food and soda companies are using to create demand for western foods that, up until recently, hadn't been available in countries such as India. Drawing from annual reports, press releases and other primary sources, Hawkes finds Coca-Cola aiming to ensure that "Coke is always within arm's reach of desire", to "make our beverages preferred by more people in more places", increase "product availability wherever people gather" and "stimulate impulse purchase behaviour". With this type of bombardment strategy and the money to implement it, will it be possible for people in India to "just say no" and choose not to shift to western food products and diets?
Public policy experts agree that trying to change the behaviour of each individual amid an abundance of unhealthy foods and advertisements is not cost effective. In the U.S., food corporations spend more than $30 billion to advertise their products in comparison to the $350 million spent by the U.S. government to conduct nutrition education.
Finding it difficult to conduct nutrition education, in what Yale researcher Kelly Brownell calls the "toxic food environment", many U.S. universities banned the sales of soda and fast food on their campuses. Though it hasn't yet banned the advertising of unhealthy foods, the U.S. has banned the advertising of tobacco products that target children. With little surplus cash for expensive nutrition education campaigns, India should consider similar measures banning placement and advertising of fast food and sodas to prevent a public health disaster.
The rich diversity of cultural traditions and agricultural regions in India has given birth to many healthy foods prepared from locally grown ingredients. The mass marketing of western foods by corporations with huge advertising budgets now threatens to send these rich food traditions — developed over thousands of years — into extinction in just a few decades. In their place, we may find a population devastated by debilitating health problems amid an economy unable to care for them. The time to prevent this is now.
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