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Public health approaches to combating childhood obesity in india: a mini‑review
Sai Ram Challa1,2, Nitya Bansal3, Hemant Mahajan3
1ICMR-National Institute of Nutrition, Hyderabad, India. drsairamnin@gmail.com.
Insights
India faces a childhood obesity crisis, with 9-12% of children affected. Effective prevention involves fiscal policies on Sugar-Sweetened Beverages (SSB), clear nutrition labelling, and marketing restrictions.
Area of Science:
- Public Health Nutrition
- Paediatric Endocrinology
- Health Policy Research
Background:
- Childhood obesity is a growing global concern, with India experiencing a 'double burden' of undernutrition alongside rising overweight and obesity rates in children and adolescents.
- National data suggests 9-12% of Indian children and adolescents are overweight or obese, necessitating urgent public health interventions.
- Effective prevention strategies require systemic changes in food and physical activity environments.
Purpose of the Study:
- To review current evidence and policy landscape for childhood obesity prevention in India.
- To identify key interventions and policy priorities for tackling the rising rates of paediatric overweight and obesity.
- To propose actionable strategies for strengthening India's approach to childhood obesity prevention.
Main Methods:
- Analysis of national surveys and meta-analyses on childhood obesity prevalence in India.
- Review of existing and developing Indian policies and programmes related to food environments, school health, and nutrition labelling.
- Synthesis of evidence supporting fiscal measures, marketing restrictions, and school-based interventions.
Main Results:
- India has implemented foundational policies like FSSAI regulations on High Fat, Salt, Sugar (HFSS) foods in schools and the PM POSHAN scheme.
- A front-of-pack nutrition labelling system is under development, and higher taxes on sugary drinks are in place.
- Key priorities for strengthening impact include strict enforcement of school food rules, marketing restrictions, and improved labelling.
Conclusions:
- India possesses essential building blocks for childhood obesity prevention but requires enhanced implementation and enforcement.
- Strengthening policies on school food, marketing, labelling, and taxation, alongside promoting physical activity and early-life interventions, is crucial.
- Rigorous surveillance, equity-focused evaluation, and transparent reporting are vital for successfully bending the paediatric obesity trajectory in India.
Abstract:
Childhood obesity is rising in India alongside a global increase, creating a double burden where undernutrition coexists with growing overweight and obesity in children and adolescents. Recent national surveys and meta-analyses indicate that 9-12% of Indian children and adolescents are obese or overweight. Prevention requires population-level strategies that reshape food and physical activity environments. Strong evidence supports fiscal measures on Sugar-Sweetened Beverages (SSB), clear Front-of-Pack Nutrition Labelling (FOPNL), and statutory restrictions on marketing to children, complemented by school and family-based programmes. India has established important building blocks, including the 2020 Food Safety and Standards Authority of India (FSSAI) regulations restricting High Fat, Salt, Sugar (HFSS) foods in and around schools, the Ayushman Bharat School Health Programme (AB-SHP), the Pradhan Mantri Poshan Shakti Nirman (PM POSHAN) meal scheme, and higher effective taxation on sugary drinks, with a front-of-pack labelling system under development. To strengthen impact, priorities include strict enforcement of school-food rules, along with provision of safe drinking water within the school settings; finalisation of interpretive labelling, comprehensive marketing restrictions across all media and retail near schools, and channelling revenue from HFSS taxation towards providing nutritious meals in schools. Safeguarding physical education and recess, promoting active school transport, and integrating early-life actions such as breastfeeding support and antibiotic stewardship are also important. Progress depends on routine surveillance for crossing of centiles, equity-focused evaluation of policy implementation and program outcomes, transparent public scorecards detailing adherence to policies and program impact, and safeguards against conflicts of interest. With rigorous and equitable implementation, India can bend the paediatric obesity trajectory at scale.
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