Early Action on Diabetes Must Begin with Informed Food Choices

A consumer reaches for a brightly packaged food on a supermarket shelf, drawn in by its appealing design and reassuring health claims. What remains largely out of sight, however, is the amount of added sugar packed into every serving. To discover the truth, the consumer must turn the package over and decipher complex nutritional information printed in small font. This information gap, seemingly small, exerts a significant influence on millions of food choices made everyday. In Bangladesh, where diabetes is an escalating public health concern, preventing this requires more than hospital-based care; it demands an empowering food environment where consumers can readily identify the health risks of the products they buy. Mandatory warning-based Front-of-Package Labelling (FOPL) offers an effective and best-buy policy intervention.

Observed annually on 14 November, World Diabetes Day serves as a reminder that tackling diabetes goes beyond early diagnosis and timely treatment; it demands action to reduce risk factors before the disease takes hold. This year’s theme, “Early Action on Diabetes,” underscores precisely this imperative. For Bangladesh, the call is particularly urgent. According to the International Diabetes Federation (IDF), approximately 13.9 million people aged 20–79 was living with diabetes in Bangladesh in 2024. More concerning, an estimated 39.1 per cent, nearly 5.4 million people, were unaware of their condition. Diabetes-related healthcare expenditure during the same year reached approximately BDT 120 billion. These statistics extend beyond illustrating the rising prevalence and economic consequences of diabetes; they expose the pressing need to strengthen preventive public health interventions and address the modifiable risk factors that contribute to its rising incidence.

Alongside the diagnosis and treatment of diabetes, changing dietary habits, particularly reducing excessive sugar consumption, and facilitating informed food choices are equally important in combating diabetes. What people eat is not determined solely by individual preference; it is also profoundly shaped by the food environment in which they live. In Bangladesh, the consumption of packaged ultra-processed food products is steadily increasing. A nationwide study conducted in 2025 found that approximately 97 percent of the respondents consumed packaged foods at least once a week.

The nutritional composition of these products raises further concerns. Another study conducted in 2023 examined nine categories of processed packaged foods across 24 brands available in Bangladesh, including chips, chanachur, fried lentils and peas, noodles, biscuits, lozenges/lollipops, milk chocolate, chutneys and ice cream. The findings revealed that the levels of salt, sugar and fat in these products substantially exceeded the WHO’s recommended daily limits. Moreover, 21 percent product labels did not provide information on sugar and salt, while that saturated-fat, salt and sugar  information was absent or unclear on many ultra-processed packaged foods. Under such circumstances, making healthy food choices becomes particularly challenging for consumers. 

Mandatory warning-based FOPL, however, can play a significant role in addressing this challenge. Rather than requiring consumers to calculate percentages, interpret complex nutritional terminology or examine lengthy ingredient lists, clear warning labels on the front of packages can immediately indicate whether a product contains excessive amounts of sugar, salt or saturated fat. This enables consumers to make more informed and conscious decisions at the point of purchase.

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Forty-four (44) countries across the globe have already adopted FOPL, with mandatory warning-label systems in 10 countries, including Chile, Mexico, Argentina and Uruguay. Evidence from these countries suggests that such policies can positively influence consumer behaviour and promote the reformulation of the products. Following the introduction of FOPL in Chile, the proportion of products requiring “high in” warning labels declined, while purchasing patterns for products high in sugar, salt, and unhealthy fats also changed significantly. In Uruguay, most consumers reported noticing the warning labels, and a substantial proportion said the labels had altered their purchasing decisions. These experiences demonstrate that simple, warning-based FOPL is increasingly emerging as an evidence-based public health policy, one that can help encourage healthier food environments. A study conducted in Bangladesh has also identified warning-based labels as the most effective FOPL approach for its consumers.

Bangladesh has made considerable progress towards introducing FOPL. The Bangladesh Food Safety Authority (BFSA) has already drafted the Safe Food (Packaged Food Labelling) Regulations, 2026, which propose mandatory black octagonal warning labels on the front of ultra-processed food packages containing excessive amounts of sugar, salt, and saturated fat. Following a public consultation, the draft was sent to the Ministry of Food on 30 June 2026. It has yet to be finalized. Food industry stakeholders have invoked arguments related to international trade rules, technical standards, and economic implications to delay or dilute the proposed regulations. They are pushing for voluntary rather than mandatory FOPL, extended implementation periods, exemptions for small packages, and other concessions.

However, to translate the call for ‘Early Action’ on diabetes prevention into practice, Bangladesh must make mandatory warning labels on the packaging of sugar-laden ultra-processed foods a public health commitment. The proposed ‘Safe Food (Packaged Food Labelling) Regulations, 2026’ must therefore be finalized without further delay, commercial interference, or ineffective exemptions, and mandatory warning-based FOPL must be implemented to safeguard public health.

The writer is chief nutritionist at BIRDEM Hospital