Food Fortification For Nutritional Security: Benefits & Risks

Government of India approved the Centrally Sponsored Pilot Scheme on "Fortification of Rice & its Distribution under Public Distribution System" for a period of 3 years beginning in 2019-20 with total outlay of Rs. 174.64 Cr. The Pilot Scheme focuses on 15 districts across 15 states, preferably 1 district per State.

Food Fortification

The addition of key vitamins and minerals such as Iron, Iodine, Zinc, Vitamin A and Vitamin D to staple foods such as rice, milk and salt to improve their nutritional content is called food fortification. These nutrients may or may not have been originally present in the food before processing.

Need

• Low Consumption of Micronutrients: 70% of people in India do not consume enough micronutrients such as vitamins and minerals.They either do not consume a balanced diet or lack variety in the diet because of which they do not get adequate micronutrients.
• Lack of Affordability of Nutritious Food: Those who are economically disadvantaged do not have access to safe and nutritious food.
• Wide Prevalence of Nutritional Deficiency Diseases: Deficiency of micronutrients or micronutrient malnutrition, also known as “hidden hunger”, is a serious health risk.
• About 70 percent of pre-school children suffer from anaemia caused by Iron Deficiency and 57 percent of preschool children have sub–clinical Vitamin A deficiency.
• Neural Tube Defects (NTDs) caused due to deficiency of Folic acid are the most common congenital malformation with an incidence that varies between 0.5-8/1000 births.
• Loss of Nutrients: Often, there is considerable loss of nutrients during the processing of food.

Importance

• Improves Health of Large Section: Since the nutrients are added to staple foods that are widely consumed, this is an excellent method to improve the health of a large section of the population, all at once.
• Improves Nutrition: Fortification is a safe method of improving nutrition among people. It helps in improving diets and in prevention and control of micronutrient deficiencies.
• Socio-culturally Acceptable: It 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 in Food Characteristics: It does not alter the characteristics of the food—the taste, the feel, the look.
• Quick Implementation: It can be implemented quickly as well as show results in improvement of health in a relatively short period of time.
• Cost-effective: This method is cost-effective especially if advantage is taken of the existing technology and delivery platforms.
• 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.
• Even when all program costs are passed on to consumers, the price increase is approximately 1-2%, less than normal price variation. Thus it has a high benefit-to-cost ratio.
• It requires an initial investment to purchase both the equipment and the vitamin and mineral premix, but overall costs of fortification are extremely low.

Risks

• Hyper-vitaminosis: Studies published in the medical journal Lancet and in the American Journal of Clinical Nutrition show that both anemia and Vitamin A deficiencies are over-diagnosed, thus mandatory fortification could lead to hyper-vitaminosis.
• Undernourishment due to Low Consumption: Nutrients don’t work in isolation but need each other for optimal absorption. Undernourishment in India is caused by monotonous cereal-based diets with low consumption of vegetables and animal protein. Thus, food fortification cannot help to eradicate undernourishment.
• Lead to Toxicity: Adding one or two synthetic chemical vitamins and minerals will not solve the larger problem, and in undernourished populations can lead to toxicity. E.g.- A 2010 study showed that iron fortification caused gut inflammation and pathogenic gut microbiota profile in undernourished children.
• Loss of Natural Substances: Natural foods contain protective substances such as phytochemicals and polyunsaturated fat that are adversely affected by the process of blending micronutrients.
• Harm Small Farmers: Mandatory fortification would harm the vast informal economy of Indian farmers and food processors including local oil and rice mills, and instead benefit a small group of multinational corporations who will have sway over a Rs. 3,000 crore market.