The bitter truth about sugar 

This week in health: the curious case of Madurai AIIMS, IRDAI’s new rules on health insurance and why sugary processed foods are harmful.

April 23, 2024 02:30 pm | Updated April 24, 2024 10:09 am IST

Image for representational purpose only. File

Image for representational purpose only. File | Photo Credit: Reuters

(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying thereYou can subscribe here to get the newsletter in your inbox.)

What is sugar? When did it become the reviled substance that it has now become? No wonder then, that the study which found that Nestle was adding sugar in its infant formula in India was welcomed with the incredulity reserved for murderers. For context, do read this report by Bindu Shajan Perapaddan: Nestlé baby products sold in India, Africa, Latin America have higher sugar content than in Europe, tests show.

Sugar is a soluble carbohydrate, loved for its sweet taste, but with growing awareness of the addiction it can cause and the damage it can do to the human body, the distancing from it has been meditated and slow. The WHO says excessive intake of threatens the nutrient quality of the diet by providing significant energy with little other nutritional benefits, leading to unhealthy weight gain and increased risk of overweight and obesity and other NCDs. Sugars are energy sources providing 4 kcal of energy per gram. However, sugars are classed as a nonessential nutrient, as they do not provide other nutritional benefits.

WHO has issued recommendations to reduce intake of free sugars throughout the life course. In both adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake. While there are sugars occurring naturally in nature, and regular consumption of these foods should be monitored for someone with diabetes, the consumption of added sugar is frowned upon. The literature to date shows that high sugar and low complex carbohydrate consumption increases the risk of overweight/obesity. Do read Maitri Porecha’s explainer on why sugary processed foods are harmful.

As far as Nestle goes, the study was conducted by the Swiss NGO, the Public Eye and International Baby Food Action Network (IBFAN). They found that sugar was added only in a few countries the addition of sugar was only in a few countries - Africa, India, and Latin America and some Asian nations- where regulations are food safety regulations are lax, speaks of double standards. The sugar introduced in the infant food would add taste to the formula, which babies would then prefer over those with no sugar added. Besides this is likely to lead to the formation of a sugar habit early in life, experts say. Despite World Health Organisation (WHO) recommendations, Indian regulators do allow a limited amount of sucrose and fructose in baby food. In keeping with Indian rules, therefore, labels on Nestle’s baby products for the Indian market clearly show that they contain added sugar.

Meanwhile, the Indian government has woken up to the dangers of added sugar in formula food and asked FSSAI to initiate action against Nestle after the report of sugar content in Cerelac appeared in the media.

Staying on sugar, Chennai-based diabetologist V. Mohan writes about the glycemic index of diets, and their importance beyond diabetes control. The Glycemic Index (GI) of a food refers to the property of the food to increase the blood glucose level and is a measure of the ‘quality’ of carbohydrates. Many nutritionists strongly believe in the deleterious effect of consuming diets with high GI and conversely the beneficial effects of taking diets with low GI. While there is a lot of evidence to tie a high GI to developing Type 2 Diabetes, what is less known is the association of high GI diets with cardiovascular disease and mortality. If diets with high GI, i.e., the ‘bad’ carbohydrates, are replaced with ‘good’ carbs which have low GI and this is combined with adequate physical activity (exercise), it could help to curb the growing incidence of premature cardiovascular disease in India.

Jacob Koshy, meanwhile, has this interesting interview with Nobel Laureate Venki Ramakrishnan who says regenerating the brain is not in the realm of possibility right now. Dr. Ramakrishnan, whose work on protein synthesis is related to one of the central causes of ageing, says that while we better understand, at a biological level, the causes of ageing and death, we are far from major breakthroughs. With several technology mavens investing millions in ageing-related research, and many others self-experimenting with supplements and therapies to halt ageing, the field is generating great interest among people of all ages. However, much of this doesn’t yet have the sound backing of scientific validation, he adds. Dr. Ramakrishnan has just published his latest book: Why We Die: The New Science of Ageing and the Quest for Immortality.

Another major story for the health sector in India this week, and for patients in general, was IRDAI removing the age bar for purchasing health insurance. Earlier, there was an age limit of 65 years to buy new health insurance policies. IRDAI’s latest move is aimed at bringing in extended health benefits to the elderly. The IRDAI directive mandates health insurance providers to develop specialised policies catering to senior citizens, and to establish dedicated channels for addressing their claims and grievances. Companies are also encouraged to develop tailored products to meet specific age-related requirements, fostering a more inclusive healthcare ecosystem.

While this might be seen as an acknowledgement of the social demographics of an ageing population, as always with insurance, there is fine print. Already insurers are indicating that the premiums for this demographic might be higher. Will it then serve the accessibility goal that it was conceived for? We’ll stay on this topic, to bring you insights and developments. 

Implying a significant shift in process, or the way things were done, the Centre now requires all cases of organ transplants, whether from living or deceased donor, to be given a unique NOTTO-ID. The Union Health Ministry has reportedly issued the directive to eliminate commercial dealing in organs, especially those involving foreign citizens. This would prevent malpractices, rerouting of organs, and ensure proper filing of documents relating to transplant, both of donor and recipient, indicating the path the organ would take to reach the latter. 

Given the long history of jurisprudence weighing in on women’s choices, particularly with reference to body autonomy and abortion rights, it is important to record this: Supreme Court allows minor rape survivor to undergo medical termination of a 30-week pregnancy. The Supreme Court on April 22 used its extraordinary powers under Article 142 of the Constitution to do “complete justice” to permit the medical termination of pregnancy of a 14-year-old rape survivor in Maharashtra. Her pregnancy is nearing 30 weeks, since the minor became aware of her condition only at a very late stage. The relief is rare as the Medical Termination of Pregnancy (MTP) Act caps the upper limit for termination of pregnancy at 24 weeks.

In the meanwhile, did you hear of the medical college that went missing? Read our edit: On the case of the Madurai AIIMS where despite three batches being admitted to medical college, there still is neither a building nor any other infrastructure in place at AIIMS, Madurai, in Tamil Nadu. 

R. Prasad writes a piece on how an inexpensive technique that is used in Tamil Nadu to treat rodenticide poisoning is proving effective and could be replicated. Inspired by the success that a team of researchers from CMC Vellore had while using plasma exchange through a centrifugal method ­— a simple and less expensive treatment — to treat liver injury among people who had consumed rodenticide poison, the Tamil Nadu government has implemented it in 15 government hospitals, saving lives in the process.

On the subject of communicable diseases, here are a couple of stories from the international arena that might interest you. The U.N. approves an updated cholera vaccine that could help fight a surge in cases. The WHO authorised the vaccine, made by EuBiologics, earlier in April. The new version, called Euvichol-S, is a simplified formula that uses fewer ingredients, is cheaper, and can be made more quickly than the old version. In a horrific attack, an Israeli shell destroyed over 4,000 embryos plus 1,000 more specimens of sperm and unfertilized eggs stored at Gaza City’s Al Basma IVF centre.

In the tail piece for the week, Rahul Karmakar reports how home voting turned into a health camp for elderly in remote Arunachal villages. Apparently, sending a medical team along with polling personnel to Kra-Daadi district in Arunachal West, one of the two Lok Sabha constituencies in Arunachal Pradesh, to enable home voting for geriatric electors and persons with disabilities (PwDs) was a last-minute decision by Election Officer Sunny K. Singh. The medical team comprising nursing officer Takhe Manju, ophthalmic assistant Koj Minu, and laboratory technician Ajay Singh was tagged along with the election team under the presumption that the targeted home voters might not have had access to healthcare in recent times. And sure enough, they found several senior citizens who had long stopped going to the primary health care centre. Whether the winners of the contestants deliver their promises or not, the electoral system has thrown out a line for these people. 

From the Health page

WHO terms pathogens that transmit through air ‘infectious respiratory particles’ or IRPs.

The WHO says the resurgence of human cases of bird flu is ‘an enormous concern’.

This one is where you listen in, as Anna Thomas talks on the relationships between women caregivers and the elderly in the Women Uninterrupted podcast.

Sridhar Sivasubbu and Vinod Scaria write on the ‘genomic accordion’ mpox viruses use to evolve, infect humans.

A recent study says the absence of full drug-susceptibility data for TB patients can result in amplifying resistance.

Dr. C. Aravinda writes on Austin Bradford Hill and his Randomised Control Trials, the technique that transformed TB treatment.

For many more health stories, head to our health page, and subscribe to the health newsletter, here.

0 / 0
Sign in to unlock member-only benefits!
  • Access 10 free stories every month
  • Save stories to read later
  • Access to comment on every story
  • Sign-up/manage your newsletter subscriptions with a single click
  • Get notified by email for early access to discounts & offers on our products
Sign in


Comments have to be in English, and in full sentences. They cannot be abusive or personal. Please abide by our community guidelines for posting your comments.

We have migrated to a new commenting platform. If you are already a registered user of The Hindu and logged in, you may continue to engage with our articles. If you do not have an account please register and login to post comments. Users can access their older comments by logging into their accounts on Vuukle.