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If sugar content lowered in pkgd goods, India can bend the curve
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Thursday, 05 March, 2026, 14 : 00 PM [IST]
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Dr Shilpa Varma
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“Hidden sugars”, sugars added during processing that are not obvious to consumers because they appear under different names or live inside packaged biscuits, ready-to-eat mixes, sauces, breakfast cereals, infant foods and even some nominally “savoury” snacks and breads and are a silent but could be potent driver of India’s mounting non-communicable disease (NCD) burden. The public-health problem is twofold: first, these sugars substantially increase daily free-sugar exposure for consumers who are unaware; second, the growth of industrial food use of sugar means packaged and processed foods are a rapidly expanding vector for excess energy intake across ages and socio-economic groups.
Global guidance is clear: free sugars ought to be limited to reduce risk of weight gain and dental caries. WHO recommends <10% of total energy (with an additional conditional benefit below 5%). This benchmark gives policy makers and clinicians a concrete target for population guidance but it is routinely exceeded in practice when hidden sugars are not accounted for.
In India, the dynamics are particularly worrying. National dietary guidance from ICMR-NIN has recently emphasised avoidance of foods and beverages with added sugars and recommends strict limits consistent with public health targets. At the same time, government and industry data show that a majority of sugar in the Indian supply chain is directed to industrial uses (beverages and food manufacturing), not just household spooning, amplifying exposure through packaged goods. These twin facts clear national guidance and growing industrial sugar use, highlight the urgency of tackling hidden sugars as a policy priority.
Epidemiologically, India’s rising diabetes, overweight and cardiovascular disease prevalence track closely with dietary transitions. The ICMR-INDIAB study and related national metabolic NCD reports document steep increases in diabetes prevalence and metabolic risk factors in recent years, driven by urbanisation, sedentary behaviour and high-energy diets. Excess intake of free sugars contributes to positive energy balance, visceral adiposity and dysmetabolism, mechanistic pathways that translate sugar exposure into increased population-level incidence of type 2 diabetes, non-alcoholic fatty liver disease, and cardiovascular disease. In short, when hidden sugars push habitual sugar intake past WHO and national recommendations, they feed directly into the biology of NCDs.
Why are hidden sugars so effective at escaping notice? First, label literacy is low and ingredient nomenclature is deliberately varied: sucrose, dextrose, maltose, corn syrup solids, fructose, fruit-juice concentrate and many syrup blends are all forms of "added sugar". Unless a consumer inspects the ingredient list closely (and knows what to look for), packaged items marketed as “low-fat”, “naturally flavoured”, or even “sugar-free” can still deliver substantial free sugars to the diet because sugar is used to improve mouthfeel, shelf life, and flavour. Second, formulation practices place small absolute amounts of sugar into many different categories- a 10-15 g sugar addition per serving in a biscuit or condiment may appear trivial, but cumulative exposure across multiple packaged items consumed daily becomes significant. Regulatory labelling often reports “total sugars” without clear distinction of free/added sugars, which compounds the consumer challenge. (ICMR has explicitly warned that “sugar-free” tags
can be misleading, as such products may still carry hidden sugars or caloric ingredients.)
The population consequences are already visible. National survey data (NFHS-5) show rising overweight and obesity prevalence across adults and increasing overweight in young children, trends that are mechanistically and temporally linked to dietary shifts toward energy-dense processed foods. These population indicators, combined with rising per-capita sugar use in industry, create a public-health environment in which hidden sugars are likely contributing materially to India’s NCD burden. Tackling hidden sugars is thus not only a nutrition education task; it is a systems-level food environment challenge, with some pragmatic actions as below-
- Label transparency and consumer literacy. Mandatory declaration of “added/free sugars” (not just total sugars) on the nutrition panel and simple on-pack interpretive labels (e.g., traffic-light or warning icons for high sugar) make it easier for consumers to compare products.
- Product reformulation and industry incentives. Since a large fraction of national sugar ends up in industrial uses, setting voluntary or mandatory reformulation targets for staples (beverages, bakery items, ready meals, infant foods) will reduce population exposure quickly. Fiscal measures, such as health taxes on sugar-sweetened beverages and subsidies for reformulation, can accelerate industry action while generating revenue for public health campaigns.
- Public procurement and institutional standards. Hospitals, schools and government can lead by example: procurement rules that restrict added sugar content and provide healthy alternatives change demand signals and protect vulnerable groups (children, in particular) from early sugar exposure.
- Clinical and community interventions that recognise hidden sugars. Clinicians and dietitians must move beyond “avoid sweets” counselling and teach patients to identify common hidden sugar sources (e.g., packaged sauces, breakfast cereals, condiments). Community nutrition programmes should equip households with simple rules e.g., prefer whole foods, check ingredient lists for multiple sugar synonyms, and limit packaged snacks for children.
In conclusion, hidden sugars in packaged foods constitute a hidden yet modifiable target for NCD prevention in India. Scientific guidance is clear, national recommendations align with global evidence, and the distribution of sugar use toward industrial food manufacture presents both the problem and the opportunity: if industry and regulators act now to make sugar content visible and lower it in packaged goods, India can bend the curve of diet-related NCDs while preserving culinary diversity and food industry livelihoods.
(The author is chief dietitian, Belle-Vue Hospital and NEC member, IAPEN India)
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