India needs a national campaign on reading food labels

Mislabelled drinks pose serious risks in a country battling childhood diarrhoea and rising diabetes

Dr Sivaranjani Santosh from Hyderabad has taken over the Internet for her efforts to ensure that sugary drinks cannot be labelled as ORS.

On October 14, the Food Safety and Standards Authority of India (FSSAI) issued a landmark directive warning against the use of the term ‘ORS’ unless the product specifically matches the precise World Health Organization-approved composition. 

Oral Rehydration Salts (ORS) is a combination of glucose, sodium, and other salts like potassium and citrate, which are dissolved in water, and used for the treatment of acute diarrhoea.

The WHO prescribes a standard oral rehydration solution with a total osmolarity of 245 mOsm/L. This composition includes 2.6 grams of sodium chloride, 1.5 grams of potassium chloride, 2.9 grams of sodium citrate, and 13.5 grams of dextrose anhydrous (sugar) per litre of water.

In contrast, several FMCG groups are selling sugary beverages containing around 120 grams of total sugar per litre as ORS, which is nearly 110 grams of extra sugar! 

This formula was inconsistent with the WHO recommendation and could cause severe diarrhoea symptoms rather than curing them. Since these were being sold as beverages in tetra packs, the companies approached the FSSAI for approvals instead of the Central Drugs Standard Control Organisation (CDSCO). 

On October 17, the Delhi High Court granted interim relief to JNTL Consumer Health India Pvt Ltd, the maker of ORSL. The court directed the FSSAI to hear the company’s representation before enforcing the order against it.

Although the ORSL packages contain a disclaimer stating that they should not be given in diarrhoea and that it is not ORS, the font size on the pack is so small that it is barely noticeable. 

This brings us to the question: do we know how to read the contents of a product we are consuming?

According to the WHO, diarrhoeal disease is the third leading cause of death in children 1-59 months of age. Each year, it kills around 443,832 children under five and an additional 50,851 children aged five to nine years.

Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year, and it is a leading cause of malnutrition in children under five years old. Especially in India, where the highest number of children are living with Type 1 diabetes in the world, these sugar-laden drinks can be avoided if we are taught to read a label correctly.

Labelling of products in India is governed by the Legal Metrology Act, 2009, and the Legal Metrology (Packaged Commodities) Rules, 2011, which make it mandatory for producers to print essential items like MRP, quantity, manufacturing, and expiry dates.

The FSSAI and the Drugs and Cosmetics Act, 1940, add another layer by making it compulsory to mention details of ingredients, nutritional information, and disclaimers, if necessary. 

However, these disclaimers or cautions are usually written in such small fonts that they are barely noticeable. There is no specific law that prescribes the font size for each commodity, as is done in the case of cigarette packets. Most importantly, there is no general awareness campaign on how one should read these labels, and what they mean.

Imagine a scenario where someone in rural India is buying a product because it is advertised by a celebrity. The product claims to be ‘organic’ and ‘sugar-free’, but all of its mandatory declarations are written in English, and the person does not know how to read them. Will the consumer be able to judge the real contents of the product? If a person is not even aware of the contents, how will they be able to report if the facts are misleading? 

In the food and safety department, the officers are overworked, especially in smaller regions where these products are bought by word of mouth, a catchy tagline, or a shiny celebrity face on the packet, not by what they contain.

What if children in schools are taught how to read labels? What if labels are in local languages? What if manufacturers are asked to write disclaimers just like those on cigarette packets?

What India needs is a robust and widespread awareness campaign around labelling to tackle the rising risks of lifestyle diseases. Knowledge of proper labelling will not only help people understand what they are consuming, but will also ensure they are not cheated financially by rapidly changing MRPs via stickers or by counterfeit products. This will help hold manufacturers accountable for any kind of misinformation.

This campaign requires a multi-dimensional approach, considering India’s diversity. Television, radio, and print media would need extensive messages in regional languages.

The government can use digital platforms to propagate a standard set of rulebooks or pamphlets, which can also be distributed through the PHCs and Anganwadi centres.

A chapter in school textbooks, a workshop with teachers, or a session in panchayat halls can take this battle to the ground level, and create citizens who think twice before consuming food that could be bad for their health.

This will help consumers not only gain health advantages, but also ensure better economic outcomes. For the broader economy, informed consumers contribute to fair market practices, reduced healthcare burdens from preventable illnesses, and more efficient resource allocation.

Government enforcement becomes more effective when aware consumers actively report violations, creating a self-regulating market ecosystem. 

Ultimately, label awareness campaigns represent an investment in public health, consumer rights, and economic fairness that can transform India's marketplace into a more transparent and equitable system.

Anish Bari and Pranjal Pandey co-founded Health Spark, a public initiative aimed at promoting awareness and dialogue around health and climate. 

(Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.)