Battle continues for doctor who taught India to spot real oral rehydration solutions formula

Pediatrician Sivaranjani Santosh embarked on a mission nearly nine years ago to prevent children and parents in India from being misled by counterfeit oral rehydration solutions (ORS). Her crusade targets what she terms "sugary packaged juices masquerading as life-saving oral rehydration salts (ORS)" that can worsen dehydration.

Santosh's relentless social media campaign against these fake ORS products successfully raised consumer awareness and prompted the Indian food regulator to ban non-standard drinks from using the ORS label. However, the battle is far from over, with misleading advertisements and deceptive labeling continuing to confuse consumers.

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I asked parents to bring what they gave their children. To my dismay, I saw that they were giving a tetra pack of juice with the brand name ORSL... It had 11g sugar per 100ml, which is almost 10 times the recommended amount of sugar ORS is supposed to have (1.35g per 100 ml).

The issue came to light in 2018 when Santosh noticed some children treated with ORS were not improving, and in some cases, were getting worse. Upon investigation, she discovered parents were administering products like ORSL, a brand containing 11g of sugar per 100ml – nearly ten times the recommended amount for standard ORS. This high sugar content, unlike the precise ratio of sodium and glucose in WHO-compliant ORS, disrupts water absorption in the intestines, potentially leading to more severe dehydration and salt imbalances.

While India is a major manufacturer of WHO-compliant ORS, the market is also flooded with electrolyte-filled fruit juices with similar-sounding names. These beverages, often sweeter and containing artificial sweeteners, are readily available and can exacerbate dehydration. Santosh continues her fight against these deceptive products, aiming to ensure that life-saving ORS formulations are accurately represented and accessible to those in need.

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Such electrolyte beverages contain significantly more sugar and some include sucralose, an artificial sweetener. They taste better, but they draw more water from the cells, making dehydration worse.