Non-communicable diseases | Sunday Observer

Non-communicable diseases

 Non-communicable diseases (NCD) rank among the first 10 causes of premature deaths in Sri Lanka. The latest available proportional mortality data, for 2014, show that 75 percent of deaths are due to NCDs. The country’s risk factors are overweight due to an unhealthy diet and physical inactivity along with the use of tobacco and alcohol, air pollution and poverty. Against this background, the Ministry of Health drew up a National Multi-Sectoral Action Plan for the Prevention of NCD (2016 to 2020) where reduced consumption of saturated fats/trans fats, sugar and salt was one of the expected outcomes. Now, to regulate salt, sugar and fat content in processed food, traffic light labelling would become mandatory for all liquid, partly-solid and solid packed food items available in the market from April 1, 2019

Traffic-light labelling for all food will be effective from April 1, 2019. Traffic-light labels are a form of interpretative front-of-pack (FOP) nutrition rating systems that provide information on the amount of calories and selected nutrients found within a specified amount of food.

The system introduced in 2016 for all beverages to indicate sugar content in all fizzy drinks, juices, and cordials will be extended to solid food, partially-solid food, and liquid food. However, this time it also includes indicating the amount of salt and fat along with the sugar content. The system will follow the ‘traffic light’ coding system with red indicating high content, orange for moderate content, and green denoting a healthy amount of salt, sugar, and fat in each serving.

It is a public health intervention to reduce chronic disease risk by improving the dietary intakes of consumers, initiated by the Ministry of Health. Dr Gamlath told the Sunday Observer said that the regulations are being formulated and will be implemented from April 1, 2019. “Currently we are planning to conduct awareness programs for students and the public on this new law before we implement it.

Medical camps

We will hold free medical camps to check the diabetic and cholesterol levels of people islandwide, to create awareness and alert them. We also have planned to conduct several awareness campaigns. We have educated the manufacturers on this, as well ” he said.

“Research conducted by the Ministry of Health showed that about 50 percent of people look at the colour code system which was introduced for beverages in 2016. Now, people are aware that too much of sugar is not good for their health. Therefore, we took another step to introduce for all foods indicators for the levels of salt, fat and sugar. The non-communicable diseases (NCD)’s such as strokes, most heart diseases and cancers, diabetes, chronic kidney disease, osteoarthritis, and osteoporosis are on the rise. We studied the world colour code system for food and understood the health benefits.

It is a great success in many countries. We have decided on cut-off points for all levels. Primary agricultural products such as rice and flour and milk, will be exempted from this system, Dr. Gamlath said.

Nutritionist and Joint Secretary, The Nutrition Society of Sri Lanka, Roshan Dele Bandara said, “The colour coding system is really good as it helps the ordinary person to easily pick food based on the sugar, salt or fat concentration levels.

Colour indicators

The colour indicators are eye catching, so it is easier for the consumers than reading nutrition value information. Though this system is good, it is lacking in many aspects and many improvements should be done. The Government and the Health Ministry should have a comprehensive plan for the entire program (Sugar, Fat and Salt levels) and they could have campaigns to achieve the required levels of health in people.

Consumers should be made aware of this system. Today, information is available everywhere but people’s reaction towards it, is different. Though they know that some products are health risks they still do want such food and consume them. We should try to achieve a greater behavioural change in people rather than just feeding them information only,” he said.

Bandara said that the system is introduced section by section by the Health Ministry. They introduced the sugar content level for beverages first and they are now doing it for fat and salt. “After implementing a law, it is important to monitor and evaluate it to improve the health levels. They should clearly do an assessment and check whether changes have happened due to the sugar colour indicators.Today, due to the global computer network, much information is shared through various applications and the major problem is the authenticity of the information. Therefore, the public should be fed the proper information. Consumers are also sometimes misled by manufacturers. Nowadays ,the larger, multi national companies reduce the concentration levels in food. They do small changes to the concentration levels and change the colour code. Also artificial sweeteners come under the green category which means it is alright for consumption.

These are misleading the consumers, so the consumers should read the entire nutrition value information before buying. They should definitely be made aware of this,” he said.

Effectiveness

The Sunday Observer also spoke to people to know how effective the colour coding system is for beverages and what they feel about the system being introduced for all solid foods which contain salt and fat. Saroj Pathirana, a father said that most people are health conscious nowadays. “This system is already practiced in many countries and this should have been introduced a long time ago. People in urban areas will know what to look for on the packaging but will that same awareness be present in the more rural areas?” he asked.

Lakshmi Jeyapriyan, a teacher says that this system is really good and that it will help to improve the health and lifestyle of Sri Lankans. “People mostly try to avoid buying beverages with the red label but they are cheap in comparison to the other colour coded beverages. Sometimes I have bought beverages with orange or green colour codes but they really are very sugary. I think that some people are deceiving the consumers,” she said.

“Knowing how to read food labels is important, not only if we have health conditions such as diabetes mellitus, high cholesterol, high or low blood pressure, or obesity where we need to follow a special diet, but it is important for all people. It is not sufficient to check only the expiry dates In addition to that, one needs to also understand the levels of added sugar, salt, macro (proteins, carbohydrates, fats), and micro (vitamins and minerals).

However, we must also be cautious when reading food labels as sometimes they can be misleading, from the advertising perspective. For example,’sugar free’ products usually include alternate sweeteners high in calories and ‘diet’doesn’t necessarily mean all the nutrients are balanced, and food labelled ‘fat-free’ food could be high in artificial additives and sweeteners to make them more palatable to consumers,” said Mohammed Rafi, an engineer.

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