A major change has just come to how food and drink items are labeled in India. After years of concern about misleading claims, the Food Safety and Standards Authority of India (FSSAI) has taken a firm stand: no product can use the label “Oral Rehydration Salts (ORS)” unless it meets the standards set by the World Health Organization (WHO).

This change is largely thanks to a determined campaign by Hyderabad-based pediatrician Dr Sivaranjani Santosh, who pushed hard to stop sugary drinks from being misleadingly marketed as ORS.

Dr. Santosh has spent eight years exposing how many companies were selling drinks with high sugar content under the name ORS, creating a false sense of health benefits. Her efforts brought attention to the danger of these drinks — especially for children and people with diabetes.

The New FSSAI Rule on ORS Labels

On October 14, FSSAI issued a new directive: no food brand may label its product as ‘Oral Rehydration Salts’ or ‘ORS’ unless it strictly follows WHO’s recommended formulation. This directive also cancels all earlier permissions that allowed use of “ORS” in product names. Those earlier rules, from July 14, 2022, and February 2, 2024, had permitted the term if the label carried a disclaimer saying: “The product is Not an ORS formula as recommended by WHO.”

Just a day later, on October 15, FSSAI clarified that using “ORS” — whether in fruit-based drinks, non-carbonated beverages, or ready-to-drink formulas — would violate the Food Safety and Standards Act, 2006. The regulator argued such labeling was “false, deceptive, ambiguous, and erroneous,” and thus breached multiple rules under the Act.

Dr. Santosh’s Emotional Moment

After the FSSAI announcement, Dr. Santosh posted a video on Instagram, visibly moved. In her caption she wrote:

“WE HAVE WON IT! A CLARIFICATION WAS ISSUED TODAY! NO ONE CAN USE ORS on their label unless it is a WHO recommended formula and no one can sell it right from today! Thank you @FSSAI @jpnaddaofficial @narendramodi. 10.20 PM- Thanks to each and every parent, doctor, Paediatrician, child, teacher, journalist, Advocate, anchor, celebrity, podcaster, influencer, educator, and every one who stood by me for this cause! Special thanks to my teachers, family, staff, @endocrinesocietyindia, and @womenpediatriciansforum.”

She declared in that video: “We have won it,” rejoicing in the success of the campaign. Her reaction resonated across social media, where many praised her persistence.

One user wrote:

“We need more people like her, we can start by questioning ourselves when we buy these things.”

Another added:

“Thank you for the service, mam. A true hero.”

A third comment said:

“The fruits of the efforts of the most tirelessly determined & ethically poised doctor of India!!!!! Take a bow, Maam!”

These reactions show the public’s emotional support for her cause.

Who Exactly Is Dr. Sivaranjani Santosh?

Dr. Santosh is a pediatrician who long warned about deceptive labeling of ORS products. She has expressed frustration at the slow pace of regulatory action. In one Instagram post, she wrote:

“So, basically, children need to die for the drug regulatory authority to wake up!”

She pointed to products such as ORSL, RebalanzVitORS, and ORSFIT that claimed to be ORS but did not follow WHO’s formula. She cautioned that drinks with high sugar substitutes can be harmful when used to treat diarrhoea.

She also argued that many deaths attributed to “diarrhoea and dehydration” do not acknowledge that sugary drinks might have worsened the condition. She urged other doctors to record exactly which fluids children received before they died from diarrhoea.

What Makes a “Real” ORS — and Why It Matters

The WHO defines its standard oral rehydration solution by its total osmolarity of 245 mOsm/L, made up of:

• 2.6 g sodium chloride

• 1.5 g potassium chloride

• 2.9 g sodium citrate

• 13.5 g dextrose (sugar)

All of this per litre of water.

By contrast, many so-called “ORS” drinks sold in India contain about 120 g of total sugar per litre, of which nearly 110 g is added sugar. Their electrolyte content is also far off the mark: about 1.17 g sodium, 0.79 g potassium, and 1.47 g chloride per litre — which do not align with WHO’s standards.

Reflecting on the regulatory decision, Dr. Santosh said:

“It was a war. Eight years of battle, three years of filing PILs, and four to five years of fighting indifference. This victory belongs not to one person, but to people’s power, all the doctors, advocates, moms, and influencers who stood with me. I stood steadfast, and we won.”

That statement sums up the long struggle she undertook.

How Can You Spot a Legitimate ORS?

Because misleading products still exist, here are steps parents and caregivers can follow:

• Check the formulation: The correct ORS should use the proportion of sugar and salts recommended by WHO. Always check whether the label matches those guidelines.

• Avoid sugar substitutes: Some brands use stevia, monk fruit, or other substitutes. These do not offer the glucose needed for rehydration and may slow recovery.

• Skip extra ingredients: Add-ons like fruit powders, herbal extracts, or spirulina are not part of the original formula and may reduce effectiveness.

• Consult trusted medical sources: While tips from social media can be tempting, always verify health advice through certified medical professionals.

• Use sachets: The safest option is WHO-approved ORS sachets from a reliable pharmacy. They have the correct proportions pre-measured so you don’t have to guess.