Abantika Ghosh 
Prime minister Narendra Modi’s star power can be a formidable ammunition in India’s fight against obesity; the idea of a cascading network of anti-obesity ambassadors will doubtless deliver the message effectively. What strikes a mildly discordant note is the message itself.
Government initiatives and a public discourse against obesity are much needed; but to attribute India’s burgeoning obesity burden to the consumption of oil alone is to miss the wood for the trees. In 2020 when the Indian Council of Medical Research brought out a comprehensive report on “What India Eats”, they found that Indians get a disproportionately higher number of calories from carbohydrates. This figure is important because obesity – which refers to the deposition of adipose tissue in the body – happens when the intake of calories exceeds their use.
Adipose tissue is the body’s way of preparing for a potentially calorie deficient future when it can be used as a last resort; that is why when people starve to lose weight the first to go are proteins – muscles.
Divergence from ideal on the Indian plate
The Indian Council of Medical Research (ICMR )report found: “…total energy (E) intake from cereals contributed to 998 Kcal/day, while visible fats and pulses & legumes contributed to 265 Kcal/day and 119 Kcal/day respectively in urban areas. In contrast, the total energy intake from cereals was much higher (1358) Kcal/day, and considerably lower from fats (145 Kcal/day), pulses and legumes (144 Kcal/day) in rural areas. Whereas, milk and milk products contributed almost similar in urban (99 Kcal/day) and rural areas (87Kcal/day).”
The report also pointed out the divergence from ideal on the Indian plate. Dietary recommendations suggest the report said, not more than 45% of energy should be contributed by cereals and millets while in India, the actual contribution was 51% in urban regions and 65.2% in rural regions.
“Pulses, legumes, meat, poultry and fish contributed to mere 11% of the total energy per day in urban areas and rural areas, as against the recommended minimum intake level of 17% of total energy from these foods,” it added. The poor protein basket nevertheless, has not been a deterrent in more and more states opting out of mid day meal eggs – the latest being Maharashtra.
The culpability of sugars (the most calorie dense variety of carbohydrates) in fuelling the obesity epidemic is also the reason why globally, one of the first items (beyond tobacco and alcohol) to be brought under a sin tax are sugar sweetened beverages (SSB). The city of Philadelphia for example taxes all sweetened beverages (including zero calorie ones) at the rate of 1.5 cents per ounce.
A recent World Health Organisation (WHO )report on sin taxes against sugary drinks tabulated that as of July 2022, excise taxes at the national level had been levied on at least one type of SSB in 108 countries globally. While India does impose a 28% VAT on SSBs (higher than other foods and drinks), any store bought cake or cookie is high on both carbohydrates and fats and come at a price that make them the snack of choice for anybody looking for a quick bite, particularly people from lower socioeconomic strata. While a packet of glucose biscuits cost Rs 5/10, a single guava in a Tier I city can cost Rs 50.
Sugar is a political minefield
But to call out sugars as a culprit is a politically fraught proposition. Sugarcane farmers and sugar mill owners exert significant political influence in states like Maharashtra and Uttar Pradesh (the two states together account for 138 Lok Sabha seats) – so much so that when Maharashtra MLA Dr Neelam Gorhe unearthed a high number of hysterectomies in women who worked in the industry, the matter was given a quiet burial without much noise.
In Uttar Pradesh, sugarcane farmers and sugar mill owners are among the highest contributors to the coffers of political parties.
In 2018 the National Democratic Alliance (NDA) government came out with a package for the relief of sugarcane farmers – incidentally hours after BJP lost a by-election in Uttar Pradesh’s Kairana which is at the heart of the sugarcane belt. A fair and remunerative price for the sugarcane crop is fixed every year by the Cabinet Committee on Economic Affairs chaired by the prime minister himself. If there is something truly bipartisan about India’s polarised political landscape, it is how the interests of the sugar industry run deep and wide and how many people associated with it sit in the Indian Parliament at any given time.
The strong political sensitivities associated with sugar make it politically expedient to make a fall guy out of oil – by no means completely innocent but only a lesser evil in the Indian context. Because every celebration we have calls for a mooh meetha (consumption of sweets) and our natural food choices weigh heavily towards carbohydrates.
Also Read: Unseen and Unheeded: India’s Looming Obesity Problem
Some years ago when I was talking to a Polish colleague, he was astounded when I told him one of the delicacies of the Bengali cuisine was aloo posto (potato and khus khus preparation) that is served with rice. “How can you have carbohydrates with more carbohydrates,” he asked! But to ask people to cut down on cereals at a time when the relationship between farmers and the government is not at its best can also come with political repercussions
For the anti-obesity campaign to pivot on oil may make for good optics and safe politics but for sensible policy making, it is important for governments not to lose sight of how much India’s non communicable disease burden derives from the excessive consumption of carbohydrates.
While the implications may be better known for diabetes and cardiovascular diseases, in both of which obesity may aggravate the condition, the spurt in non alcoholic fatty liver disease (NAFLD) which is of more recent provenance is also attributed increasingly to the consumption of excessive processed foods, refined carbohydrates and sugary drinks (lack of exercise, unhealthy lifestyle are additional risk factors) and not necessarily fats as is commonly believed. In India NAFLD is sometimes seen even in non-obese patients.
An anti-obesity campaign that ignores carbohydrates is only half a beginning.
Abantika Ghosh is a journalist and public policy professional. She posts on X @abantika77. Views are personal.