 Hello and welcome to NewsClick. Today we are going to talk about the issue of obesity with Dr. Amit Sian Gupta, who is the convener of people's health movement in India. So India is still facing this problem of malnutrition and stunting in children to a huge extent. But now we're seeing that obesity has also doubled in the past decade. World Over as well, World Health Organization just published a report that there will be more obese children than under-nourished children in the next five years. But sir, obesity is still seen, there's still this huge misconception around it that it is a sign of prosperity. It's not seen or addressed as a health issue. So how accurate is this viewpoint? First of all, it is important to understand that obesity is also a manifestation of malnutrition. So there is nothing like over-nutrition. There is good nutrition and there is bad nutrition which is malnutrition. So if you really look at the spectrum of malnutrition then, we have which is an abiding problem in India, extreme prevalence of under-nutrition where an estimated anything between 30 to 50 percent of the Indian children receive nutrition that is not enough. They don't basically they're hungry. Then you have a rising tide of people, both children as well as adults and adolescents who are eating the wrong kinds of food leading to obesity and a third, which is called the micronutrient deficiency, which is related to both the first and second, where because you're not eating enough or eating the wrong kinds of foods, there are elements that are necessary for good nutrition that you're not receiving, though you may seem to be eating enough. So it's been called the double or the triple burden of malnutrition in common parlance today. Global food practices, they are largely shaped by say world trade organization and free trade agreements. Even in India, we had the 1991 economic reforms. Then we had World Trade Organization's agreement on agriculture. Then there was the World Bank's country assistance, the loan India got from World Bank. Now, all of these resulted on this pressure on India to basically diversify its agriculture, it reduce the import taxes. So all of that impacted agricultural practices in India. How did that impact basically change nutrition? Just to remember that we started from a base, you're talking about the 1990s, but we started from a base where already you had a very high prevalence of under nutrition in the country. In fact, it has been called the South Asian enigma that if you, for example, compare India or other South Asian countries to even countries in sub-Saharan Africa, you'll see that economically, apparently this region is doing much better relative to countries in sub-Saharan Africa, but the levels of under nutrition in India and other South Asian countries are something like double or three times what you'll see in even in the poorest regions of the world in sub-Saharan Africa. So we already started from a situation where we had very high levels of under nutrition. Now, on top of that, we had the agreement on agriculture, which is perhaps the most fraudulent agreement among all those that constitute the World Trade Organization agreements. Because essentially, to put it simply, what it allowed is that it allowed the northern countries, the rich capitalist countries, to continue with their subsidies to domestic agriculture and it put various restrictions on the ability of countries of the South to actually give support to their own agricultural sector. What this meant was on one hand, it meant that immediately agriculture in the South, including in India, became uncompetitive in the global market, allowing imports of agricultural commodities into the Indian market one. Second, it promoted what is called export-led agriculture. So what happened was that India or Indian farmers were encouraged to grow what are called cash crops for the global export market. And this meant shifting cultivation practices away from needed grain production, especially coarse grain production, millets. Now millets have traditionally been the main source of good nutrition among the poor, jawar, bajra and a range of millets that you find in different parts of the country. Now you can see now that much of that land is now shifted either to producing poor quality rice and wheat or to producing cash crops such as tobacco, cotton, etc. Leading to actually the poor being denied some of the important sources of good nutrition, including proteins and other minerals. But over and above that, what we are also seeing is a persistence of hunger, which is basically under nutrition. So the promise of the trade regime that everybody will benefit, that the peasants in India who constitute the majority of the population still will have money in their hands and because of that they will get good nutrition, has not actually happened. And India continues to be the most undernourished region in the world. From the agrarian distress that you read about everywhere today is largely a manifestation of the unequal terms of trade that you have on one hand in the global food system and on the other of course domestic policies which have sort of rolled back welfare measures which were designed to provide nutritional support in the form of public distribution systems, etc. So not only are these farmers not able to grow healthier food for themselves, there is also this, we are seeing this aggressive marketing of processed and ultra processed foods and beverages. So yeah, so basically I mean of course that has a huge impact on obesity. But then how can we reduce the consumption of such foods and how much will that impact obesity? So there is this interesting comparison that you can actually see now emerging that all over the world now wherever obesity is emerging is a big problem. Contrary to believe that this is a manifestation of people becoming richer, you see that obesity actually is being seen in populations who are poorer. So for example in the US where obesity is a huge problem, it is the African-American population where you see a higher incidence of obesity than the better of white population. Now all this is because the way people consume food and procure food is changing towards a situation where more and more food is being marketed by mega corporations and agribusiness corporations. And these foods are notoriously poor in nutritional content and have very high levels of sugars which basically lend to obesity. So actually if you look at the food and beverages industry they use three kinds of enticements. High sugar, high fat, high trans fat and high salt. Now all these three actually sugar you need to a very small degree. I mean actually you don't need sugar in the form of refined sugar. You should actually be getting carbohydrates from more complex sugars. So you don't really need sugar in the pure form. You don't actually need salt at least in the amounts that you have in processed foods. And trans fats you don't need. But all these three are enticements. So it has, for example, research has showed that the craving for sugar actually comes from the same part of the brain where you get the craving for cocaine. So sugar is actually addictive. And children, very small children, they don't have a prediction to actually demanding sugar. But because they are fed from childhood or early childhood, they are fed high sugar food, including biscuits, which is ubiquitous. They get into the habit of consuming sugar. And this is what actually the agribusiness companies and the food and beverages companies depend upon. The entire addictive capacity of these so-called soft drinks or beverages is based on the addictive capacity of sugar. And that's what keeps you hooked. And this is having a major impact on obesity, and now especially among the poor or the not so well of. And second, which you are starting to see in India. You don't have it to the extent that you have in the US or even in countries such as Thailand, in Asia, et cetera, where it's cheaper, it's cheaper for the poor to buy ultra-processed food of the kind that we were talking about rather than to buy from the market fresh food and cook it at home. Till now no country has reversed its obesity epidemic. What needs to be done? Does the government need to step in with some regulations and basically reduce the penetration these beverages and food companies have? What should the government now be doing to at least try to start reducing this? First, it's important to understand that virtually the same factors which lead to the poor being undernourished are also the factors which lead to the poor becoming victims of obesity. Second, the same social determinants, the societal reasons which lead to undernourishment, also lead to obesity in the sense that, for example, the rich today can afford to go to gyms to exercise. The poor can't. Public spaces are contracting. So the poor don't have any more access to the poor children, don't have access unless you go to a fancy school. You can't play football these days in most cities in India. It is conditions of living which determine whether people are obese today. Now the penetration of the ultra-processed food industry in India is still relatively low. Among poor households, I don't think it's more than, say, 5% or something like that, but it's growing and it's growing rapidly. And if you really look at the situation in other countries, it's likely to grow in the coming years quite sharply. So the kind of things that you need to put in place in India, because India is currently at the tail end of the obesity epidemic. It's not yet at the level at which many countries, even developing countries such as South Africa is in. So one, make provision for good food, fresh food, to be available. Create the conditions for that to be available. So for example, the public distribution system is something that needs to be strengthened. Second, you need to curtail the ability of the food and beverages corporations to enter the market in the way that they've entered. They're advertising campaigns. Unfortunately, we see many government programs now collaborating with food and beverages companies, with companies such as Nestle and Britannia, et cetera. This should be an absolute no-no, that government programs should separate themselves from food and beverages company. You need to have regulations of labeling of what kind of nutrients are available or are in the packaged foods that are sold in the market. You need to have regulations, for example. In many countries in the North, including the United States, of not allowing some kinds of packaged foods and beverages into schools. So now, the exhortations are victim blaming, asking people to eat better and exercise more. That's the sum total. If you see even on the obesity day, this is what the government kept doing and this is what the WHO does, walk more, eat better. There's no point in blaming the poor. You have to create the conditions in which people can eat better and exercise more. We can basically conclude that the government needs to really step into this issue and take some huge steps to reduce the strength that we're seeing. That's all the time we have. Thank you, Dr. Sian Gupta. Thank you for watching this clip.