Fake ORS: How to Spot the Sugary Drinks FSSAI Just Banned

For a product that costs less than a cup of chai, ORS has saved more lives than almost any drug in modern medicine. So it stings to learn that a lot of what sells under that name in Indian shops is not ORS at all. It is sugar water in a clever bottle. After a regulatory crackdown that took the better part of a decade to land, the rules have finally changed, and the burden now falls on you to read the packet.

If you keep a stash of rehydration drinks for the summer, for a child's loose motions, or for a hangover, this is worth ten minutes. The difference between the real thing and the fake one is not marketing. In a sick toddler, it can be the difference between recovery and a hospital drip.

What real ORS actually is

Oral rehydration salts are a precise mix, not a flavour. The version the world settled on is the WHO low-osmolarity formula: sodium chloride, potassium chloride, sodium citrate and glucose in carefully fixed amounts. The science that makes it work is the sodium-glucose pump in your gut wall. Glucose and sodium have to arrive together, in roughly equal measure, for the intestine to drag water back into the body. Too much sugar and not enough salt, and the chemistry runs backwards.

The number that matters is osmolarity, and the target is about 245 mOsm/L. That is deliberately low. An older, more concentrated recipe was replaced years ago because the lower-osmolarity version cut vomiting, reduced stool output, and meant fewer children needed intravenous fluids. A drink that is loaded with sugar sits at a far higher osmolarity. Instead of pushing water into your bloodstream, it pulls water out of your body and into the gut, which in a person with diarrhoea is exactly the wrong direction.

The trick that fooled a generation of parents

Here is how the con worked. Take a sweet, fruit-flavoured glucose drink, splash the letters "ORS" across the front, and price it like a health product. Parents reach for the familiar three letters their paediatrician told them to trust. The fine print, where it exists, rarely makes clear that the contents bear little resemblance to the medical formula.

These ready-to-drink "ORS" beverages typically carry far more sugar than the WHO recipe allows and a fraction of the sodium. A child with diarrhoea who is given one of these is, at best, getting a sugary placebo and, at worst, getting a drink that deepens the very dehydration it claims to treat. Multiply that by millions of households in a country where diarrhoeal illness is still a leading cause of childhood death, and the mislabelling stops being a marketing quibble.

Why it took eight years to fix

The correction did not come easily. A Hyderabad paediatrician, Dr Sivaranjani Santosh, spent roughly eight years pushing regulators to stop the misuse of the ORS name. The food regulator, FSSAI, first moved back in April 2022, restricting the use of "ORS" on labels and ads. Companies with registered trademarks challenged it, and within months the rule was diluted to let them carry on using the name with disclaimers.

The decisive action came much later. Through orders issued on 14 and 15 October 2025, FSSAI ruled that no food or drink may carry the term "ORS" unless it conforms to the WHO-recommended formula. Crucially, the regulator closed the obvious loophole: using ORS with any prefix or suffix counts as a violation too, so a clever brand name no longer gets a pass. Earlier permissive guidance from 2022 and 2024 was withdrawn. The Indian Academy of Pediatrics publicly backed the move, stressing that ordinary electrolyte drinks are not interchangeable with medical ORS.

How to read the packet in ten seconds

You do not need a chemistry degree to separate the real from the fake. Run through this quick checklist before you buy:

1. Look for the formula, not the slogan. A genuine product lists the WHO low-osmolarity composition and often states an osmolarity near 245 mOsm/L. If the front shouts a fruit flavour and the back hides the salts, be suspicious.
2. Check the sugar. If sugar or fructose sits near the top of the ingredients list, or the drink is sweet like a juice, it is not true ORS.
3. Sodium should be substantial. Real ORS has a meaningful amount of sodium. A barely-there salt content is a red flag.
4. Prefer the plain sachet. The boring, government-style WHO-ORS sachet you dissolve in water is the gold standard. The glossy ready-to-drink bottle usually is not.
5. Be wary of 'electrolyte' and 'energy' branding. These words are doing marketing work, not medical work.

When in doubt, ask a pharmacist for a WHO-ORS sachet by that description rather than by a brand you saw advertised.

Using ORS the right way

Buying the correct product is only half the job. People routinely get the preparation wrong, which quietly defeats the purpose.

• Dissolve the whole sachet in exactly the volume of clean water printed on the pack, usually one litre or 200 ml. Splitting a sachet to make a weaker mix throws off the salt balance.
• Use water, nothing else. Do not mix ORS into milk, juice or a soft drink, and never add extra sugar to improve the taste.
• Sip slowly and often. Small frequent amounts stay down better than a large gulp, especially when there is vomiting.
• Discard after 24 hours. A made-up solution left out can grow bacteria, so prepare a fresh batch the next day.
• Add zinc for children. For a child with diarrhoea, zinc supplements for 14 days alongside ORS shorten the illness and reduce the chance of it returning. This pairing is standard paediatric advice and badly underused.

Keep breastfeeding or normal feeding going through the illness. Starving a child "to rest the stomach" is an old myth that does more harm than good.

When water and ORS are not enough

ORS treats and prevents mild to moderate dehydration. It is not a cure-all, and there are moments to stop self-treating and get to a doctor fast. Seek medical help if you see sunken eyes, no urine for many hours, a child too lethargic to drink, persistent vomiting, blood in the stool, or a high fever. Infants dehydrate quickly, so the threshold for getting help should be lower the younger the patient.

The broader lesson outlasts any single product recall. A trusted three-letter word was rented out to sell sugar, and it took a lone doctor the better part of a decade to win it back. The regulation has caught up, but old stock lingers on shelves and online listings change slowly. Until the market fully cleans itself up, the most reliable safeguard is the one you already have: turn the packet over and read what is actually inside.