Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:
(a) the salient features of Eat Right India programme;
(b) the manner in which this programme helps to reduce country’s disease burden;
(c) whether the disease burden is passing from communicable to non-communicable disease and the diet-related diseases such as diabetes, hypertension, and obesity are rising rapidly in the country; and
(d) if so, the details thereof and the remedial action taken in this regard?
(a) & (b): Under Food Safety and Standards Act, 2006, Food Safety and Standards Authority of India (FSSAI) is mandated to ensure safe and wholesome food to the people. FSSAI has launched Eat Right India movement on 10th July, 2018 with the aim to provide people safe and healthy food through sustainable food systems. This movement is a collective effort of all stakeholders in the food system– the government, food businesses, civil society organisations, experts and professionals and consumers. It encompasses various initiatives, both regulatory and empowerment approaches, targeted at food businesses and consumers. Tagline ‘Sahi Bhojan, Behtar Jeevan’ forms the foundation of this movement. Eat Right India has following key actions namely;
(i) formulate new regulations to promote healthy eating;
(ii) train and build capacity of various stakeholders in the food ecosystem such as food handlers, administrators, frontline health workers etc.;
(iii) certify various food businesses from clusters of street food vendors to restaurants, schools and campuses based on benchmarks for food safety and hygiene;
(iv) nudge food businesses to reformulate packaged foods into healthier options and to use safe and sustainable packaging materials;
(v) ignite large scale social and behavioural change among the people of India towards safe, healthy and sustainable eating habits.
(c): Indian Council of Medical Research (ICMR) has informed that the India State-Level Disease Burden Initiative as a part of the Global Burden of Disease study, 2016 reported that the per capita disease burden measured as disability-adjusted life-years (DALY) rate dropped substantially for most communicable, maternal, neonatal, and nutritional diseases (CMNNDs) between 1990 and 2016 across all epidemiological transition level (ETL) groups, but rates of reduction for CMNNDs were slowest in the low ETL state group. By contrast, numbers of DALYs increased substantially for Non Communicable Diseases (NCDs) in all ETL state groups. The all-age prevalence of most leading NCDs increased substantially in India from 1990 to 2016, and a modest decrease was recorded in the age-standardised NCD DALY rates. The major risk factors for NCDs, including high systolic blood pressure, high fasting plasma glucose, high total cholesterol, and high body-mass index, increased from 1990 to 2016, with generally higher levels in higher ETL states; ambient air pollution also increased and was highest in the low ETL group.
(d): Health is a state subject, the central Government supplements efforts of State Government through technical and financial supports. In order to combat the major Non Communicable Disease (NCDs) including cancer, Government of India is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) for interventions upto district level under the National Health Mission(NHM), with focus on strengthening infrastructure, human resource development, health promotion & awareness generation, early diagnosis, management and referral to an appropriate level institution for treatment and follow up to non-communicable diseases (NCD). To tackle the challenge of Non Communicable Diseases (NCD), 637 NCD Clinics at District level and 4460 NCD Clinics at Community Health Centre level have been set up under NPCDCS. Treatment for NCDs is also available at other health facilities run by the Central and State Governments.
With Ayushman Bharat, India has launched health care services in a holistic manner to include preventive and promotive health care. A population level initiative of prevention, control and screening for common NCDs (diabetes, hypertension and common cancers viz. Oral, breast and cervical cancer) has also been rolled out, as a part of comprehensive primary health care. Under this initiative, frontline health workers such as Accredited Social Health Activists (ASHA) and Auxiliary Nurse Midwives (ANM), inter alia, are leveraged to carry out screening as well as to generate awareness about the risk factors of NCDs among the masses. The initiative is under implementation across the country. Screening for common NCDs is also an integral part of service delivery under Ayushman Bharat- Health and Wellness Centres.
Further, some of the steps taken by FSSAI to promote healthy diet and, thereby, help reduce diet related diseases include notification of following regulations:
i. Standards for fortification of 5 key staples viz. Wheat flour and Rice (with Iron, Vitamin B12 and Folic acid), Oil & Milk (with Vitamins A and D) and Double fortified Salt (with Iodine and Iron) as well as fortification of processed foods to address issue of micronutrient deficiency and diseases caused by it.
ii. Limiting Trans fatty acids to not more than 3% by weight in Oils and Fats from 1st January, 2021 and to not more than 2% by weight by 1st January, 2022. Also, the limit of 2% by mass of total oil/fats present in all the food products in which edible oils and fats are used as ingredient has been notified to be effective from 1st January 2022.
iii. Limiting Total Polar compound to be a maximum of 25% in used cooking oil and 15% in fresh and unused cooking oil.
iv. Safe food and balanced diet regulations for promoting safe food and healthy diets for school children. Foods which are referred to as food products high in saturated fat or trans-fat or added sugar or sodium (HFSS) cannot be sold to school children in school canteens/mess premises/hostel kitchens or in an area within fifty meters from the school gate in any direction. Marketing/advertising of such products is also prohibited.
v. Standards on health supplements, nutraceuticals, prebiotics and probiotic products which fall in category of functional foods. Functional foods provide benefits beyond basic nutrition and play a role in reducing or minimizing risk of certain diseases and health conditions.
vi. Revised Labelling and Display Regulations with new provisions on food allergens, nutritional information (menu labelling) for specified restaurants and food service establishments etc to enable consumer to make an informed choice.