India’s G20 presidency has highlighted the critical national and international priorities including food security, nutrition, health care and sustainable development for our children and future generations. The unanimously adopted New Delhi declaration has underlined these commitments. Childhood and adolescence are the crucial phases where nutritional choices hold the key to lifelong health and they demand immediate attention especially given the context that India is witnessing an unprecedented surge in overweight, obesity and non-communicable diseases among children and adolescents. Conversations around these issues have been now raised to the forefront and there is an urgency to fix our food and provide them with a conducive food environment to choose healthy, consume healthy and grow healthy.
The food environment is shaped by 5As – Availability, Accessibility, Affordability, Acceptability and Accommodation of healthier options by the vendors (in what they sell) as well as the consumers (in what they choose). To accelerate efforts to tackle the personal and commercial determinants influencing poor food choices among adolescents, a group of academic and development partners formed a consortium and conceptualised the ‘Let’sFixOurFood’ campaign. The campaign includes a two-way dialogue process involving adolescents along with policymakers, survey on nudges of food choices and examining policy environment. Being an important partner of the initiative, engaged in forming, functioning and nurturing a consortium to address obesogenic food environments, we got to examine programmatic and regulatory measures being employed globally. They range from giving teeth to the laws on restricting advertising and marketing of unhealthy foods; front-of-pack labelling (FoPL); taxing high fat, sugar and salt (HFSS) foods. However, the most immediate, long lasting and sustainable approach that is the cornerstone for success of any such measures is empowering adolescents with nutrition literacy, which in simple terms means the ability to comprehend and apply nutritional information.
Navigating the changing dietary landscape: Traditional dietary patterns in India have been undergoing a seismic shift, driven by urbanisation, globalisation, and the increased availability of processed foods. The traditional diet, rich in whole grains, fruits, and vegetables, is giving way to diets high in refined carbohydrates, sugars, and unhealthy fats. A recent report by the World Health Organization and Indian Council for Research on International Economic Relations (ICRIER) informs us that the ultra-processed foods (UPFs) have grown over 37% annually between 2011 and 2021 with chocolates, sweet confectionaries, beverages and salty snacks witnessing the highest sales. Adolescents, influenced by advertising, marketing, media, accessibility, peer pressure and the feeling of ‘bliss’ these foods offer, tend to increasingly embrace these dietary transitions.
There is an urgent need to foster healthier eating habits among adolescents as they are in the transformative phase of growth and development, and any investment in empowering them nutritionally holds immense potential to shape their future health trajectories. With approximately a fifth of our population being adolescents, altering their food environments carries far-reaching consequences. It’s time to recognise the urgency of equipping our youth with the knowledge and skills needed to make informed dietary decisions. But how do we go about it? Integrating nutrition in the school curriculum in an incremental and more systematic manner than what we currently have, is the solution that is often posited. But academic syllabi are viewed both by schools and children mostly for scoring marks. Therefore, such inclusions in the textbooks alone can hardly equip them with the knowledge, appreciation, and skills to make informed choices. Therefore, nutrition literacy should be skill-based and enrich the skills and not just knowledge. But how do we achieve this? The answer is simple, just concentrate on three necessary nutrition skills and attempt to make them universal just like the basic road traffic skills, driving skills or banking skills. The three important skills our young generation must be equipped with for navigating through complex food environments are:
(i) Skill to distinguishing between healthy and unhealthy foods: Adolescents should be armed with a solid foundation in nutrition, emphasising the significance of diversifying their diets incorporating fruits, vegetables, whole grains, lean proteins, eggs, dairy and healthy fats into their diets. This should also include the awareness about how the nutritional value gets altered as the extent of processing increases and why UPFS and HFSS foods should be avoided. This certainly will foster critical thinking skills to evaluate their food choices whether in home-made or away-from-home foods. They could even be encouraged to question claims and assess the impact of food on their overall well-being.
(ii) Choosing healthy from locally available foods: India’s rich culinary traditions offer a treasure of nutritious, locally sourced foods. Encouraging adolescents to explore these options not only promotes health but also sustainability. Nutrition education, to transform into a nutrition literacy skill, should stress the health benefits of locally grown and seasonal produce. By being able to choose the healthier options from the locally available foods adolescents can savour the nutritional advantages of indigenous foods while preserving food cultures. Research has shown that practical experience, such as involving in cooking and kitchen/community gardens fosters a deeper appreciation for healthier options.
(iii) Reading food labels: Food labels serve as essential tools of public health communication and the skill to read and understand their contents can shape food choice decisions. However, understanding labels can be a daunting task for adolescents. We have proven through our studies that with a little help, adolescents can easily pick up this life skill and unlock the nutrition information to interpret labels, comprehend key concepts such as serving size, nutrient contents, and ingredient lists. This skill can also empower them to identify concealed additives, excessive sugars or sodium and unhealthy fats and the extent of processing.
Nutrition literacy, indeed, is the basis on which the success of any other policy or regulatory measure hinges. While our advocacy for regulating marketing and advertising of UPFs, introduction of FoPL and stricter economic measures to discourage HFSS foods should continue, empowering our adolescents with the above-mentioned three essential skills is a clarion call to action. This certainly would be our first step towards fixing food environment for us and our future generations.
This article is authored by SubbaRao M Gavaravarapu, head, Nutrition Information, Communication and Health Education (NICHE) Division, ICMR- National Institute of Nutrition, Hyderabad.