Two-thirds of Indian adolescents swayed by food ads; higher taxes on sugary, fatty foods may help curb rising obesity

The survey of 143,000 adolescent respondents was conducted in 2022 as part of the Let’s Fix Our Food initiative, a public-private partnership between the Public Health Foundation of India, the Indian Council of Medical Research, National Institute of Nutrition, and UNICEF.

The findings are currently undergoing peer review for publication in a scientific journal.

Unhealthy food advertising, often using celebrity endorsements and games, heavily influences young people’s food choices, contributing to rising obesity and related diseases. The policy brief stated that in India, 90% of ads for children and youth on TV are for High Fat, Sugar, and Salt (HFSS) foods. Studies show such ads increase consumption; for example, children watching cartoon food ads ate 45% more.

It said that current Indian advertising rules, especially the 2022 guidelines, are weak, lacking clear definitions for “junk foods” or child-targeted ads. India must strengthen these rules with clear definitions and wider scope to protect everyone, not just children. Countries like Chile and South Korea prove strong, mandatory ad restrictions work.

With projections from the World Obesity Atlas 2022 indicating that over 27 million Indian children and adolescents could be affected by obesity by 2030, the survey highlighted that unhealthy eating habits and insufficient physical activity are key drivers of overweight and obesity among young people.

The survey found that nearly half (49.46%) of respondents receive most of their nutrition information from schools. However, economic barriers play a significant role, with 30.7% of adolescents citing high prices as an obstacle to healthy foods. 

While a large majority (72.58%) of adolescents said they do read nutrition information on food products, over half (62.81%) said this information should be simplified.

Additionally, around 43.88% of adolescents believe that providing more information about unhealthy food items could deter them from consumption. 

The outcomes of the LFOF initiative, including a detailed policy brief, were recently discussed at a high-level stakeholder consultation in the presence of Dr V.K. Paul, member, NITI Aayog, and D Rajiv Bahl, director general, ICMR.

To combat this growing crisis, the initiative urges the government to tighten regulations on advertisements for unhealthy food products targeting children.

Other crucial recommendations include introducing health taxes on high fat, sugar, and salt (HFSS) foods and ensuring clear, simplified nutrition information on food packaging. 

“Develop guidelines for clear front-of-pack nutrition information on packaged foods and regulate HFSS food consumption. Introduce health taxes on HFSS foods. Enforce the ban on HFSS foods in and around educational institutions, as per FSSAI guidelines. Implement programs to make healthy foods more affordable and accessible and Avoid partnerships with corporations promoting HFSS foods among adolescents,” the policy brief said. 

Prof. Monika Arora, Vice President, Research and Health Promotion, Public Health Foundation of India (PHFI), stated, “The recommendations such as the introduction of health taxes on HFSS foods and clearer front-of-pack nutrition labelling are presently under discussion. They have been shared with relevant stakeholders. These discussions are part of a growing national and global movement towards creating healthier food environments for children and adolescents.” 

Addressing HFSS Food Marketing

On the taxation front, the document said that health taxes are crucial in India to combat obesity and related diseases driven by unhealthy foods like sugary drinks. It said that the WHO endorses taxation as a cost-effective solution, already adopted by over 70 countries. 

A modelling study on fiscal policies in India found that a 20% tax on sugar-sweetened beverages (SSBs) could reduce overweight and obesity by 3% and type 2 diabetes by 1.6% with the largest relative effect expected among young rural men. “Extending similar strategies to unhealthy foods especially those aggressively marketed to children could play a critical role in safeguarding public health,” Prof Arora said. 

Dr Soumya Swaminathan, former WHO Chief Scientist and ICMR Director General, welcomed the crucial findings of the survey, reiterating that the rising trends of obesity and non-communicable diseases (NCDs) in India are directly linked to the significant impact of advertising on adolescents’ food choices. This, coupled with poor diet and lack of physical activity, predisposes them to NCDs, making immediate action essential to reverse the trend. 

She emphasized the need for strict advertising regulations to prevent unsubstantiated claims, especially for products targeting children with appealing characters or gifts, which are often high in fat and sugar. She also called for effective front-of-pack labeling, suggesting a clear A, B (healthy) and C, D (unhealthy) system based on fat, sugar, and salt content, rather than the proposed star labeling by FSSAI.

Furthermore, she advocated for health taxes on tobacco, sweets, and high-fat/sugar foods, similar to those in countries like Thailand. While acknowledging that such taxes in India currently contribute to the general treasury, she stressed that ideally, these funds should directly benefit public health schemes and educational campaigns to deter unhealthy consumption.

Echoing these concerns, Dr. Suranjeet Chatterjee, Senior Consultant at the Internal Medicine Department, Apollo Hospitals Indraprastha in Delhi, emphasized the critical need for strict regulation of advertisements in India. He highlighted that endorsements by film stars and other prominent figures significantly impact not only children but also adults. Dr Chatterjee stressed that food labeling must clearly indicate the amounts of fat, sugar, salt, and calories. He noted a concerning shift in food consumption patterns, leading to a rise in heart disease, blood pressure, and diabetes at much younger ages. 

“Earlier, very rarely would patients in the age group of 30-35 years come with problems of heart disease, but now, the percentage has increased in the age group of 25-35 years,” he stated, underlining the urgency of addressing these lifestyle-related health issues.

“The findings of the report indicate that 68% of adolescents are influenced by food advertisements, and nearly 31% reported that high food prices prevent them from eating healthy. These insights highlight the urgent need to improve affordability and accessibility of nutritious foods for young people. Addressing childhood obesity must remain a national priority, with stronger policies on food environment, nutrition education, physical activity, and front of pack nutrition labeling and its skill-based literacy, supported by community engagement and cross-sectoral collaboration, said Preetu Mishra, Nutrition Specialist, UNICEF.

The findings reinforce the need for system-level policy interventions to reshape the food environment. Among the key recommendations is the introduction of health taxes on HFSS foods (Food high in fat, salt and sugar), which is supported by global and regional evidence showing their impact on reducing consumption of unhealthy foods and incentivizing better industry practices.

WHO recommends taxation as one of the most cost-effective tools. An increasing number of countries have taken steps to implement fiscal policies that promote healthy diets, with 115 countries taxing sugar-sweetened beverages nationally as of February 2024. An additional 41 countries have applied national taxation on a variety of unhealthy food categories, Mishra added. 

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