Diets high in refined sugars, salt and saturated fat are implicated in an ever-growing global health crisis that is marked by a high prevalence of obesity, cardiovascular disease, hypertension, diabetes and death. In SA, more than one in eight children under the age of five are already overweight and two in three women and one in three men are either overweight or obese.

To counter the non-communicable disease (NCD) crisis, the department of health has proposed the mandatory use of warning labels on unhealthy packaged food products. Business Day Dialogues LIVE in partnership with the Healthy Living Alliance (HEALA) and its “Better Labels. Better Choices.” campaign, hosted a panel discussion around the current health crisis and the need for bolder front-of-package warning labels to help consumers make healthier food choices.

Makoma Bopape, a lecturer at the department of Human Nutrition and Dietetics at the University of Limpopo, said that obesity is increasing in SA along with deaths from NCDs linked to obesity. In fact, diabetes has moved from the tenth to the sixth cause of death. This impacts SA’s health costs and is a consequence of consuming too many ultra-processed foods high in added sugar, salt and saturated fat. The nutrition information currently on the back of food packaging is mostly small and difficult to understand.

Bopape pointed out that it was the duty of government to stand up to the power of the industries producing these foods, by legislating clear front-of-package labelling that enables consumers to make healthier choices. Currently, about 70% of food available for sale in stores is ultra-processed. The proposed legislation combined with consumer education means that shoppers will be able to identify food with high amounts of salt, sugar and saturated fat

NCDs such as heart disease, hypertension and diabetes are the leading cause of death worldwide and represent an emerging health crisis, said Mikateko Mafuyeka, a researcher at the SAMRC/Wits Centre for Health Economics and Decision Science (Priceless SA). The World Health Organisation (WHO) has called on member states to implement clear nutrition labelling and to restrict the marketing of all foods and drinks that are high in sugar, salt or saturated fat, or contain any artificial sweetener.

In 2016, Chile implemented policies to improve the country’s diet and health by legislating mandatory labels for unhealthy foods; restricting marketing to children; and reducing the availability of junk foods in schools. While there was no discernible effect on profits or employment, there were clear benefits to health: between 1 January 2015 to 31 December 2017 there was a 10.2% decline in the consumption of sugar, a 4.7% decline in sodium content purchases and a 3.9% decline in saturated fat purchases, according to medical journal, The Lancet. “Labels give individuals the power to make better food choices,” said Mafuyeka.

SA’s proposed labelling includes a triangle-shaped warning of artificial sweeteners and high levels of sugar, saltsaturated fat, said Petronell Kruger, a researcher at the SAMRC/Wits Centre for Health Economics and Decision Science (Priceless SA). The new legislation aims to protect children both from unhealthy choices and unhealthy marketing strategies. Ultra-processed-food companies use algorithms to specifically target poorer communities and have lawyers shaping the narrative against labelling. HEALA counteracts this on behalf of voiceless communities with no representation, advocating equitable access to nutritious food for all South Africans.

According to Kruger there is push-back from the food industry, which claims that the legislation would make it incur high costs; would be a deterrent to foreign investors; and would restrict their use of trademarks. HEALA says the costs would be negligible; that fresh local food is better for children than packaged foods from abroad; and that images that are harmful to children should indeed be banned.

Kruger said, however, that the discussions on the proposed legislation are proceeding transparently and in good faith.

Angelika Grimbeek, a Policy and Research manager at HEALA, pointed out that unhealthy food advertising is directed very effectively at children. The proposed legislation aims to protect children (anyone under 18) by introducing strict marketing restrictions, such as no sports-star endorsements, no cartoon characters, and no tokens, free gifts or clothing.

NCDs are complex diseases and difficult to explain, said Grimbeek. Poorer communities are disproportionally at risk and have less understanding of the benefits of healthy food choices. The new labels are intended to be easy to read and understand while unhealthy choices will be banned in the school environment, in tuck shops and as part of the national school feeding scheme.

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