Kunal has been working with the logistics and supply team of the beverage company Pepsi for more than 20 years. From mega PR events to religious ceremonies, temple functions, jagrans or fancy birthday parties, he is the man summoned to supply stacks of Pepsi's aerated soft drinks.
Not only does Kunal swear by the goodness of the Pepsi, ever since his son Akash was born, it's the diet that he has fed him, second only to milk. As Akash grew up, he would typically fuss about eating breakfast, until a nonchalant Kunal would tell his wife to stop pushing the child. With the wave of a hand, he would say, "Chal koi nahin beta, Pepsi pi le." (No worry, son, drink Pepsi).
Akash is now a 15-year-old junk food addict and suffers from acute childhood obesity, weighing nearly 60 kilos.
He studies in a private school which closes for the day well before the government school where his mother teaches physics and mathematics. Coming home early, he pulls out a Rs 50 note from the household money stashed in the kitchen and runs down to the roadside dhaba to eat a greasy meal of dal makhni and butter naan, or paneer cutlets or rolls, or chowmein or aloo tikki, depending on his mood.
"I have told him not to switch on the gas stove when I am not home," explains his mother. "Since we don't have a microwave, I have to let him eat hot food outside."
Public health challenge
The World Health Organisation classifies childhood obesity as one of the most serious public health challenges of the 21st century, affecting the urban areas of low and middle income countries. Within India, Delhi tops the charts as the metro city with the largest number of obese children.
A survey released last year by the Associated Chambers of Commerce and Industry of India on childhood obesity has claimed that one in every 10 schoolchildren in the National Capital Region between the age of 13 and 16 is overweight and therefore at risk of developing heart diseases.
“About 35% of the parents give Rs 40-Rs 100 to their children to buy food from school canteens and around 51% of the children spend Rs 30-Rs 50 on pastas and noodles, which could be building up to cause obesity,” the survey said.
Obesity is part of India's nutrition crisis. The International Food Policy and Research Institute’s Global Hunger Index, released in October 2014, while commending India for reducing the number of malnourished children by 13 percentage points between 2005-'06 and 2013-'14, draws attention to the prevalence of "hidden hunger" in the country in the form of severe vitamin and mineral deficiency.
An obese child also suffers from undernourishment due to wrong eating habits, the report says. "Hidden hunger is often hard to detect," it states, "but is potentially devastating, as it weakens the immune system, stunts physical and intellectual growth, and can lead to death."
When Akash was in class eight, during one of his regular visits to his paediatrician at Paschim Vihar, he was referred to nutritionist Dr Manika Gupta, who has been treating young patients for 25 years, but has never been in greater demand.
"We develop taste. We are not born with it,” said Gupta, her voice rising above the sound of a whirring fan in her cool shady ground floor apartment in West Delhi’s Punjabi Bagh. The youngest patients she consults come with wobbly heads at six months of age. When their growth charts are traced, some babies show alarming weight gain tendencies. Even then, parents rarely consider it a problem. It is only when the monthly check-ups show the child’s body mass index as abnormally high that they are referred to Gupta.
“The stomach is like a sack," said Gupta. "The more you feed it, the more it stretches, making the child consume beyond its means.”
Gupta regularly sees babies weighing 6-7 kilos who are being fed large quantities of milk and processed foods amounting to more than 1,000 kilo calories a day. That's the calorie requirement of a child, usually one-year-old, who weighs 10 kilos.
The toughest part of Gupta's job is changing the-fatter-my-baby-the-better mindset that makes parents feed their baby at every given chance. The side effects might not show right away but the excessive feeding forces a child’s appetite to expand more than what the body needs. Years of consuming extra calories lays the ground for obesity and related illnesses. India is the world’s diabetic capital with 62 million people suffering from the disease.
The first step to stem the obesity tide is to change food habits. This is easiest done with babies. With adolescents, it gets tougher since it requires their cooperation and pro-active participation, both of which are difficult to win.
When I walked in one hot March afternoon to meet Akash and broached a conversation on food, he straightened his slouching body, looked up from his TV and disclaimed with some boredom, “I hate junk food.” His mother is clear that she has neither time to whip up fresh salads and juices for him nor the resources to hire cooking help. She is busy coaching Akash for the next three crucial years of high school as he enters his tenth grade. “I am thinking once he completes school, he will be more independent and can join a gym and easily lose weight. Don’t you think?” she asked, eager for reassurance.
Gupta claims that about 10% of her young patients refuse to put in the effort required to shake off bad habits. But the rest, she says, are keen to go the whole mile. Once they understand that a change in sedentary lifestyle is the cure, parents drive their kids for swimming lessons, aerobics, tennis coaching and karate classes to help them burn calories.
But in a city of extreme income inequality such as New Delhi, not everybody can afford this. Recent studies in America argue that obesity and poverty are linked. Poor American families depend heavily on processed foods that are low in nutritive value and cheaper to purchase. Finding extra-curricular activities for their children unaffordable, they are unable to mitigate the side effects of sedentary lifestyles. India might soon be catching up this trend.
A half-way solution, said Gupta, could lie in getting the food industry to produce vitamin fortified food. "The children are not going to stop eating junk food," she said. "The least we can do is make it more healthy to consume." What happens then if Lays makes multivitamin enriched chips? And Coca Cola makes an iron fortified Pepsi? It’s a moot question.
As I leave Akash's home, he is negotiating his snack menu with his mother. It is a tug-of-war between what he wants – the neighborhood chaat wala’s aloo papdi chaat – and his mother's suggestion of something homemade. While she sees me out, Akash shouts from the balcony, “Mummy please yaar, na meri na aapki, ek plate alu tikki la do!” (Mummy, neither of us wins, please get me a place of alu tikki!)
Shriya Mohan is a media fellow of the National Foundation for India and Save the Children and is researching urban malnutrition in Delhi.