Two major Indian studies have provided compelling evidence that warning labels are the most effective form of front-of-pack labelling (FOPL) to reduce the consumption of ultra-processed foods.
Published Jun 04, 2025 | 12:53 PM ⚊ Updated Jun 04, 2025 | 12:53 PM
Ultra-processed food items. (iStock)
Synopsis: Nutrition Advocacy in Public Interest – India (NAPi) called for the mandatory implementation of front-of-pack warning labels on food items. The central purpose of the FOPNL warning system is to clearly signal whether a product is high in calories, sugar, fat, or sodium.
India is experiencing an alarming surge in non-communicable diseases (NCDs). According to a recent report by the Indian Council of Medical Research (ICMR), the prevalence of diabetes has reached 11.4 percent — affecting one in every nine individuals — while prediabetes affects 15.3 percent (one in seven).
Hypertension is prevalent in 35.5 percent of the population (one in three), generalised obesity in 28.6 percent (one in four), abdominal obesity in 39.5 percent (one in three), and hypercholesterolemia in 24 percent (one in four).
The Comprehensive National Nutrition Survey (CNNS) 2016 had highlighted the gravity of the situation, revealing that more than half of individuals aged between five and 19 years exhibit biomarkers associated with NCDs.
In light of this critical public health scenario, Nutrition Advocacy in Public Interest – India (NAPi) called for the mandatory implementation of front-of-pack warning labels. In a position statement released on Tuesday, 3 June, the organisation strongly rejected the 2022 draft “Star Rating” model, arguing that it is misleading and disproportionately benefits the food industry.
“Front-of-pack nutrition labelling on pre-packaged ultra-processed foods is not a marketing tool — it is a public health intervention,” said Dr Arun Gupta, National Convener of NAPi, during a press briefing on Front-of-Pack Nutrition Labelling (FOPNL) systems for food and drink products high in fat, sugar, and salt (HFSS).
The central purpose of the FOPNL warning system is to clearly signal whether a product is high in calories, sugar, fat, or sodium. Products containing excessive amounts of more than one of these nutrients should display multiple warning labels — one for each concerning component.
Guideline 15 of the ICMR-NIN Expert Committee’s Dietary Guidelines for Indians 2024 advises individuals to “minimise the consumption of high fat, sugar, salt (HFSS) and ultra-processed foods (UPFs).” The guideline underscores that foods high in fat and sugar are energy-dense, providing a large number of calories while offering little in the way of essential nutrients such as vitamins, minerals, and dietary fibre.
Regular consumption of these foods not only contributes to overweight and obesity but also displaces healthier dietary choices that supply crucial macronutrients (including essential amino acids and fatty acids), dietary fibre, and micronutrients (such as vitamins, minerals, phytonutrients, and other bioactive compounds). Deficiencies in these nutrients can lead to anaemia, impair cognitive development, hinder learning and memory, and heighten the risk of developing NCDs.
The guideline further explained that ultra-processed foods are particularly detrimental to health due to their poor fibre and micronutrient content, combined with excessive amounts of added fats and sugars. Despite these concerns, UPFs remain widely consumed because they are highly palatable, inexpensive, and readily available — even in remote areas.
Crucially, the guideline cautions that fortifying or enriching such nutritionally poor products does not make them wholesome or healthy. While food fortification is an important public health strategy to combat specific nutrient deficiencies, especially through staples like fortified cooking oil, salt, and cereals, it cannot offset the fundamentally poor nutritional profile of ultra-processed foods.
A public interest petition has been filed in the Supreme Court of India under Article 32 of the Constitution, seeking the implementation of clear and mandatory Front-of-Pack Warning Labels (FOPWL) on packaged food items. The matter was heard on 9 April by a bench comprising Justice JB Pardiwala and Justice R Mahadevan.
The petition challenged the Indian Nutrition Rating (INR) system, a star-based labelling model introduced in draft form by the Food Safety and Standards Authority of India (FSSAI) in 2022. Critics argue that the INR system is confusing and potentially misleading, as it allows nutritionally poor products to obtain higher ratings through the addition of small amounts of so-called “positive” nutrients.
In its affidavit to the court, the FSSAI detailed its statutory authority under the Food Safety and Standards Act, 2006, including its mandate to regulate food labelling. It noted that under the 2020 labelling regulations, it had proposed amendments introducing the INR system, which assigns food products a star rating from 0.5 to 5 to indicate their overall healthfulness.
The draft rules were released for public consultation in 2022, during which more than 14,000 comments were received from industry representatives, public health professionals, and consumers.
Acknowledging the progress made by the FSSAI, the Supreme Court directed the Expert Committee overseeing the matter to finalise its recommendations and submit a report within three months. The court further instructed that any necessary amendments to the food labelling regulations be completed and implemented thereafter. A compliance review is scheduled for three months later to ensure that the regulatory process is on track.
Speaking at a press briefing, Professor K Srinath Reddy, Founder President of the Public Health Foundation of India, underscored the limitations of the star rating model.
“Star ratings are inherently suggestive of approval, as any star-based system typically signals endorsement or quality,” he said. “Even if the number of stars is meant to reflect varying degrees of healthfulness, the system fails to adequately convey the risks associated with high levels of salt, sugar, and unhealthy fats. In contrast, warning labels clearly communicate the potential harm posed by such ingredients.”
Two major Indian studies have provided compelling evidence that warning labels are the most effective form of front-of-pack labelling (FOPL) to reduce the consumption of ultra-processed foods.
A study conducted by the ICMR–National Institute of Nutrition (ICMR-NIN) found that warning labels had a stronger impact on consumers’ perception of a product’s healthfulness compared to other labelling formats. Remarkably, even a single warning symbol was sufficient to prompt consumers to make more cautious and informed food choices.
In comparison to the Nutrition Star Rating (NSR) system, warning labels were more successful in discouraging the selection of even moderately unhealthy products.
Another significant study, a randomised controlled trial involving 2,869 adults aged between 18 and 60 years across six Indian states, published in 2022, further confirmed the superiority of warning labels.
While all FOPL formats had some positive effect on consumer understanding and behaviour, warning labels stood out. They significantly enhanced consumers’ ability to identify unhealthy food products, proving to be the most effective labelling system for guiding healthier choices among the Indian population.
Several countries in Latin America, including Chile, Mexico, Uruguay, Brazil, and Peru, as well as Israel, have adopted warning labels as their official FOPNL systems. These countries have seen significant changes in both consumer behaviour and industry practices as a result.
During a press briefing, Dr Chandrakant Lahariya, Founder Director of the Foundation for People-Centric Health Systems, highlighted Chile as a leading example in this field.
He explained that Chile’s approach to front-of-pack warning labels has demonstrated clear success. The labelling system explicitly marks products with warnings such as “High in Sugar,” “High in Salt,” and “High in Saturated Fat.”
This model has had a twofold impact. First, food manufacturers, concerned about potential declines in sales due to negative labelling, began reformulating products to reduce levels of harmful ingredients.
Second, the visibility of warning labels prompted consumers to become more aware of the nutritional content of the foods they purchased, leading to healthier eating habits and more informed purchasing decisions.
Chile’s experience underscores how well-designed warning labels can serve not only as a public health tool but also as a catalyst for positive change within the food industry.
(Edited by Muhammed Fazil.)
