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Indian Academy of Pediatrics Guidelines on the Fast and Junk Foods, Sugar Sweetened Beverages, Fruit Juices, and Energy Drinks

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Abstract

Justification

In view of easy availability and increasing trend of consumption of fast foods and sugar sweetened beverages (fruit juices and drinks, carbonated drinks, energy drinks) in Indian children, and their association with increasing obesity and related non-communicable diseases, there is a need to develop guidelines related to consumption of foods and drinks that have the potential to increase this problem in children and adolescents.

Objectives

To review the evidence and formulate consensus statements related to terminology, magnitude of problem and possible ill effects of junk foods, fast foods, sugar-sweetened beverages and carbonated drinks; and to formulate recommendations for limiting consumption of these foods and beverages in Indian children and adolescents. Process: A National Consultative group constituted by the Nutrition Chapter of the Indian Academy of Pediatrics (IAP), consisting of various stakeholders in private and public sector, reviewed the literature and existing guidelines and policy regulations. Detailed review of literature was circulated to the members, and the Group met on 11th March 2019 at New Delhi for a day-long deliberation on framing the guidelines. The consensus statements and recommendations formulated by the Group were circulated to the participants and a consensus document was finalized.

Conclusions

The Group suggests a new acronym ‘JUNCS’ foods, to cover a wide variety of concepts related to unhealthy foods (Junk foods, Ultra-processed foods, Nutritionally inappropriate foods, Caffeinated/colored/carbonated foods/beverages, and Sugar-sweetened beverages). The Group concludes that consumption of these foods and beverages is associated with higher free sugar and energy intake; and is associated with higher body mass index (and possibly with adverse cardiometabolic consequences) in children and adolescents. Intake of caffeinated drinks may be associated with cardiac and sleep disturbances. The Group recommends avoiding consumption of the JUNCS by all children and adolescents as far as possible and limit their consumption to not more than one serving per week. The Group recommends intake of regional and seasonal whole fruits over fruit juices in children and adolescents, and advises no fruit juices/drinks to infants and young children (age <2 y), whereas for children aged 2–5 y and >5–18 y, their intake should be limited to 125 mL/day and 250 mL/day, respectively. The Group recommends that caffeinated energy drinks should not be consumed by children and adolescents. The Group supports recommendations of ban on sale of JUNCS foods in school canteens and in near vicinity, and suggests efforts to ensure availability and affordability of healthy snacks and foods. The Group supports traffic light coding of food available in school canteens and recommends legal ban of screen/print/digital advertisements of all the JUNCS foods for channels/magazines/websites/social media catering to children and adolescents. The Group further suggests communication, marketing and policy/taxation strategies to promote consumption of healthy foods, and limit availability and consumption of the JUNCS foods.

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Funding

Funding: None. Competing interest: None stated.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Delhi, 110 095, India

    Piyush Gupta & Dheeraj Shah

  2. Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India

    Praveen Kumar & Srikanta Basu

  3. Department of Pediatrics, Hamdard Institute of Medical Sciences and Research, New Delhi, India

    Nidhi Bedi & Rekha Harish

  4. Department of Pediatrics, Ram Manohar Lohia Hospital, New Delhi, India

    Hema Gupta Mittal

  5. Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, India

    Kirtisudha Mishra

  6. Department of Pediatrics, Safdarjang Hospital, New Delhi, India

    Sumaira Khalil

  7. Sree Mookambika Institute of Medical Sciences, Kanyakumari, Tamil Nadu, India

    Ke Elizabeth

  8. Department of CTARA, IIT and Shrimati Malati Dahanukar Trust, Mumbai, India

    Rupal Dalal

  9. Indian Academy of Pediatrics, Mumbai, India

    Upendra Kinjawadekar, R. Remesh Kumar, Bakul Jayant Parekh, Santosh T. Soans & Digant Shastri

  10. SUT Hospital, Thiruvananthapuram, Kerala, India

    Kristin Indumathi

  11. Solapur, Maharashtra, India

    Sheetal S. Gandhi

  12. Breastfeeding Promotion Network of India, New Delhi, India

    J. P. Dadhich

  13. SCB Medical College, Urkal University, Bhubaneswar, Odisha, India

    Niranjan Mohanty

  14. Gajra Raje Medical College, Gwalior, MP, India

    Ajay Gaur

  15. Bhopal, MP, India

    A. K. Rawat

  16. Maulana Azad Medical College, New Delhi, India

    Raghavendra Singh

  17. Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Sciences and Research, New Delhi, India

    H. P. S. Sachdev

Authors
  1. Piyush Gupta
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  2. Dheeraj Shah
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  3. Praveen Kumar
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  8. Ke Elizabeth
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  9. Rupal Dalal
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  16. Ajay Gaur
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  17. A. K. Rawat
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  18. Srikanta Basu
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  19. Raghavendra Singh
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  20. R. Remesh Kumar
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  21. Bakul Jayant Parekh
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  22. Santosh T. Soans
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  23. Digant Shastri
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  24. H. P. S. Sachdev
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Consortia

Pediatric and Adolescent Nutrition Society (Nutrition Chapter) of Indian Academy of Pediatrics

Contributions

Contributors: All authors were part of the National Consultation (Annexure 1) that formulated these Guidelines. PG, DS, PK and DiS conceived the Consultation and Guidelines, prepared its agenda, and executed administratively. NB, HGM, KM and SK extensively reviewed the literature and also wrote the first draft of respective sections assigned to them. Review of literature was peer reviewed by PK, DS and PG. The draft recommendations were prepared by DS. KEE, RD, RH, USK, KI, SSG, JPD, NM, AG, AKR, SB, RS, RRK, BJP, STS and DiS actively participated in the consultation and/or subsequent discussions and provided critical inputs at every stage to finalize the draft recommendations. HPS led the consultation and discussions and crystallized the output. He provided intellectual inputs and overall guidance at every step. RRK, USK, RH, STS, BJP and DiS provided the administrative support from the Indian Academy of Pediatrics and coordinated between the Consultative Group and Executive Board members of the Academy. The final document was drafted by NB, HGM, KM, SK; compiled by NB; and edited by DS, PK and PG. All authors approved the final Recommendation paper.

Corresponding author

Correspondence to Piyush Gupta.

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Gupta, P., Shah, D., Kumar, P. et al. Indian Academy of Pediatrics Guidelines on the Fast and Junk Foods, Sugar Sweetened Beverages, Fruit Juices, and Energy Drinks. Indian Pediatr 56, 849–863 (2019). https://doi.org/10.1007/s13312-019-1612-5

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