The developing world is facing a new health crisis: obesity.
Since 1980, obesity rates have doubled in more than 70 countries. Globally, more than 2 billion people – 30 per cent of the population – suffer from illnesses associated with being overweight or obese, reports the Institute for Health Metrics and Evaluation at the University of Washington.
The University of Washington research, released this year and based on research up to 2015, shows 35 per cent of adults in Egypt are obese. China and India have the highest numbers of obese children, with 15.3 million and 14.4 million respectively. Even in Bangladesh, where obesity is low at 1 per cent, deaths related to high BMI increased by 133 per cent in just 25 years.
Diets high in sugar, fat and salt and sugary beverages - junk food diets - are a risk factor for multiple health conditions, including obesity. But could the junk food risk be even more of a challenge for the developing world?
Not the same products
The nutritional content of fast foods can be completely different in developing markets, versus the same items in Europe. In French-produced documentary Global Junk Food (airing Thursday August 3, 8.35pm on SBS), filmmakers discovered that a chicken burger bought at a multinational chain in India contained 5 grams of sugar, while the same menu item contained just 2 grams of sugar in France. Nuggets had twice as much saturated fat in India versus France; fries, a whopping six times more saturated fat.
“Low- and middle income countries form the largest growing markets and therefore are fertile ground for aggressive marketing of unhealthy foods like soft drinks and fast foods,” according to the World Heart Federation.
Why so much sugar and salt?
“One of the main reasons for the use of sugars and salts in food production is to extend the shelf life and to enhance the textures of the food product – the fullness, crispiness, crunchiness and overall ‘mouth feel’,” explains Dr Nenad Naumovski, Assistant Professor in Food Science and Human Nutrition at the University of Canberra, and a former chef. “At high levels, sugar and salt … reduce the microbial spoilage.”
“Putting more salt, fat and sugar in products is about taste, it’s also about economics,” says Professor Bruce Neal, a Director of the George Institute for Global Health in Sydney. “If you take a low-quality product, which is cheap, then add fat or sugar, which is also cheap, then you increase its taste, texture and durability.”
So many food companies boost the fat/sugar/salt content when they can.
Prof Neal also believes cultural standards come into play. “If you’re in a country where there’s a lot of salty food, to make your burger competitive you’ll need to put more salt in it,” he says.
Junk food just tastes good, regardless of where you buy it. We are biologically programmed to enjoy it, says Dr Naumovski. “There is some suggestion that the taste for sweet and fatty foods has an evolutionary basis, such as eating the ripe fruit, which is usually sweeter, and fatty foods, which carry us through times of famine or low foods sources. Some researchers have also suggested that energy-dense foods can specifically ‘fire-the-brain’ to select them, even if they do not taste that good.”
Regulation? What regulation?
There is very little control on food marketing in the developing world, and in parts of the developed world, too. Which means it can be marketed to school children. Even at school. As Global Junk Food reveals, although the logo on his distinctive red and yellow costume is concealed, and there are is no mention of the brand, Ronald McDonald can visit schools and childcare centres in Brazil – where one in three children are overweight (and one in two adults are overweight).
In 2008, some of the world’s biggest food companies signed ‘responsibility pledges’, promising to limit advertising to kids under 12. There have been other initiatives to promote healthy eating and curb fast-food marketing. But a World Health Organisation bulletin last year reported that while some progress had been achieved, further action was required “to protect young people from the harmful impacts of the marketing of unhealthy food and beverage products – especially given the rising prevalences of obesity and diet-related noncommunicable diseases worldwide”.
“The developing world has less regulation, but it would be a gross overstatement to suggest the developed world is doing anything effective in this space,” says Prof Neal. “When you look at the voluntary code for marketing food to children in Australia in detail, it’s absolutely useless – because it is voluntary. Every company was able to set its own rules as to what was acceptable or unacceptable in marketing to children. Most people would think of regulation as ‘government setting down a law’, but it’s not.”
Junk food brands are finding ways around codes, anyway, such as ‘advergaming’: publishing free game apps marketed to children, complete with exposure to their (cartoon-like) products.
So what do we need for better regulation? Governments and the public to take a stand, says Prof Neal. “It’s the obligation of these companies to make money as effectively and efficiently as they can, to maximise profits for shareholders. I’m sure they don’t want to harm children or people. We’ll only get on top it if we have a government that says, ‘This has to stop’. If governments really wanted to (regulate junk food), they could. I don’t think it’s that the industry is ‘smart’ or ‘one step ahead’. It’s that governments don’t make it a high priority. It would be a tough sell to both industry and constituents.”
Those constituents, the consumers, says Prof Neal, believe they are well-informed and able to make rational choices. “They don’t see themselves as being manipulated by advertising. They don’t want a nanny state. Of course, the food advertising industry plays very well off that.”
Filmed in Brazil, India and France, Global Junk Food investigates the actions of brands such as Coca-Cola, McDonald’s and Domino’s Pizza. Watch it 8.35pm Thursday August 3 on SBS, then on SBS On Demand.
Lead image: Sajjad Hussain via Getty