Does India need Food Fortification? – UPSC GS3

Central government is running a pilot scheme to fortify rice and distribute it through the PDS for a period of three years starting 2019-20, with a total outlay of Rs 174.64 crore.

The Central government is funding 90% of the scheme for the north-eastern and hilly states, and 75% for the rest of India.

The pilot focuses on 15 districts across 15 states, preferably one district per domain.

According to the National Family Health Survey (NFHS-4):

India has slipped to 101st position in the Global Hunger Index (GHI) 2021 of 116 countries, from its 2020 position of 94th.

Thus, fortification is necessary to address deficiency of micronutrients or micronutrient malnutrition, also known as “hidden hunger”, a serious health risk. Unfortunately, those who are economically disadvantaged do not have access to safe and nutritious food. Others either do not consume a balanced diet or lack variety in the diet because of which they do not get adequate micronutrients. Often, there is considerable loss of nutrients during the processing of food.

One of the strategies to address this problem is fortification of food. This method complements other ways to improve nutrition such as such as diversification of diet and supplementation of food.

Currently government is promoting fortification in following 5 food items:

Rice: Department of Food & Public Distribution (DFPD) has been running a “Centrally Sponsored Pilot Scheme on Fortification of Rice & its distribution through Public Distribution System”. The scheme was initiated in 2019-20 for a three-year pilot run. This scheme will run till 2023 and rice will be supplied to the beneficiaries at the rate of Re 1 per kilogram.

Wheat: The decision on fortification of wheat was announced in 2018 and is being implemented in 12 states under India’s flagship Poshan Abhiyaan to improve nutrition among children, adolescents, pregnant mothers and lactating mothers.

Edible oil: Fortification of edible oil, too, was made compulsory across the country by FSSAI in 2018.

Milk: Fortification of milk was started in 2017 under which the National Dairy Development Board of India (NDDB) is pushing companies to add vitamin D.

High benefit-to-cost ratio: Food fortification has a high benefit-to-cost ratio. The Copenhagen Consensus estimates that every 1 Rupee spent on fortification results in 9 Rupees in benefits to the economy. While an initial investment to purchase both the equipment and the vitamin and mineral premix is required, the overall costs of fortification are extremely low.

Also, fortification ensures a threshold level of nutrition at a very low cost—just 15 paisa to fortify a litre of oil and 2 paisa for a litre of milk.

No socio-cultural barriers: Fortification does not require any changes in food habits and patterns of people. It is a socio-culturally acceptable way to deliver nutrients to people

No alteration of food characteristics: It does not alter the characteristics of the food like the taste, aroma or the texture of the food

Quick implementation: It can be implemented quickly as well as show results in improvement of health in a relatively short period of time.

Wide reach: Since the nutrients are added to widely consumed staple foods, fortification is an excellent way to improve the health of a large section of the population, all at once.

FSSAI Regulations: In October 2016, FSSAI operationalized the Food Safety and Standards (Fortification of Foods) Regulations, 2016 for fortifying staples namely Wheat Flour and Rice (with Iron, Vitamin B12 and Folic Acid), Milk and Edible Oil (with Vitamins A and D) and Double Fortified Salt (with Iodine and Iron) to reduce the high burden of micronutrient malnutrition in India.

Nutritional Strategy: India’s National Nutritional strategy, 2017, had listed food fortification as one of the interventions to address anaemia, vitamin A and iodine deficiencies apart from supplementation and dietary diversification.

Impact on foetal development: Consumption of excess iron by pregnant women can adversely affect foetal development and birth outcomes. These children have increased risk of contracting chronic diseases.

Loss of natural protective substances: Sometimes, fortification can have the opposite effect. Natural foods contain protective substances such as phytochemicals and polyunsaturated fat that are adversely affected by the process of blending micronutrients.

Market-driven solution: The researchers are worried that the push towards fortification is more to help the industry than the people and is an international market driven solution and without any scientific logic.

Mandatory fortification will create markets that will be hard to withdraw when we have achieved the target of reduced micronutrient deficiency.

High cost: The fortification expenditure of only the rice delivered through the social safety networks will cost the public exchequer about Rs 2,600 crores annually.

Impact on small industries: Fortification creates an assured market for multinationals. It could threaten the livelihoods of small units across India. Like, in case of rice and oil processing.

No direct link b/w anaemia & iron deficiency: There is no direct link between anaemia and iron deficiency. Anaemia is high among poor children in the rural areas but iron deficiency is more among the urban and rich across the country.

A diverse and quality diet is more helpful: Instead of fortification, the quality of diet should be improved. Increasing the intake of foods from animal sources and fruits would be more helpful. National Institute of Nutrition, too, recommended that a diverse natural diet is required to meet the normal population need of micronutrients in its Nutrient Requirements of Indians released 2020.

Food can be grown through Amrut Krishi, an organic farming technique that would lead to an increase in food nutrition.

Another solution was breast feeding with proper latching techniques. It could make critical impacts on nutrition deficiency in the critical first 1,000 days.

Kitchen gardens: A study in Maharashtra has shown that vegetables grown in organic kitchen gardens increase haemoglobin levels.

Include less processed or unpolished rice in the public distribution system. This would make sure that rice bran, a rich source of various micronutrients reached people.