Whole‐of‐society monitoring framework for sugar, salt, and fat consumption and noncommunicable diseases in India

Abstract

India has experienced a rising prevalence of cardiometabolic risk factors in the past 15 years: the prevalence of diabetes has increased from 5.9% to 9.1%, hypertension from 17.2% to 29.2%, and obesity from 4% to 15%. The increase is among all socioeconomic groups and in urban and rural populations, though the quantum of change varies. A concomitant increase in per capita consumption of sugar from 22 to 55.3 g/day and total fat from 21.2 to 54 g/day was observed, with significant differences between states of high and low human development index (HDI). Per capita consumption of sugar, salt, and fat is consistently and significantly associated with overweight and obesity but variably associated with the occurrence of hypertension and diabetes. Market research shows that approximately 50-60% of total salt, sugar, and fat in Indian markets is procured by bulk purchasers, generally for manufacturing processed food items. This sector of the Indian economy is among the fastest growing, with several policy incentives. It is not clear from most of the data sets whether available information on per capita sugar, salt, and fat consumption has considered the contribution of processed and ready-to-eat food items. The unprecedented changes of rapid urbanization, mechanization, and globalization demand close monitoring of social, developmental, and economic determinants. This paper provides pieces of evidence to justify a whole-of-society (WoS) framework for monitoring the inputs, processes, and behavioral components of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) in India.

A comparison study on the prevalence of obesity and its associated factors among city, township and rural area adults in China

“…This was consistent with the ecological study of the UK and other previous studies. [24][25][26] Also, a Swiss study found a positive association between obesity and salt intake. 27 This was also consistent with the policy and action on nutrition and health promotion in many countries.…”

Convergence in urban–rural prevalence of hypertension in India

“…Per capita fat and oil consumption has also increased during the last 40 years. 42,45 Per capita consumption of sugar has increased from 22 to 55 g per day and total fat from 21 to 54 g per day in the last 15 years, more in rural populations. 43 National Nutrition Monitoring Bureau has also reported that fat consumption in India has increased significantly.…”

“…This has led to 60% increase in number of towns in the last 20 years. 9 This process is known as 'diffuse urbanization' and has led to changes in hypertension risk behaviors and risk factors-sedentariness, stress, increased salt, sugar and fat intake and obesity, 1,42 and has led to more rapid increase in hypertension in rural populations. There is epidemiological evidence that population demographic changes in India have added to environmental risk factors for hypertension.…”

Food and Nutrition Systems in India Change as a Result of the Nutrition Transition: The Implications on the Food and Nutrition System in Relating to Changes in the Food Supply and Dietary Intakes

“…Fat intake increased by 7% in India from 1980 to (FAO, 2004. Accordingly, the diet has shifted from one that is high in monounsaturated fat, present in olives, nuts and seeds, to a diet that is high in saturated and trans fats, present in fatty meats, dairy products, vegetable oil, snacks food and fast food (Arora et al, 2014). Currently, India imports about 18 million metric tons of vegetable oil yearly (Directorate General of Commercial Intelligence and Statistics -India, 2016).…”