Food Fortification: Addressing the Micronutrient Gap

THIRUVANANTHAPURAM:
In a briefing, today, organized by the Karnataka Health Promotion Trust (KHPT), supported by the Global Alliance for Improved Nutrition (GAIN), and in collaboration with the Food Safety Division, Kerala, experts addressed the media on the benefits of food fortification and the urgent need for its widespread adoption.

The event was inaugurated by Ajaya Kumar, Commissioner, Kerala Commissionerate of Food Safety, Govt. of Kerala. Mr Kumar said that food fortification is receiving significant consideration in the community. He added, “The government and food manufacturers have implemented different schemes and projects to drive the addition of micronutrients into food. As a public health policy this will go a long way to help to reduce dietary deficiencies in India.”

In food fortification, micronutrients (vitamins and minerals like Folic acid, Vitamin B12, Vitamin D, etc) are added to staple foods like rice, wheat flour, milk, and edible oils. Deficiency of micronutrients results in poor cognitive and learning abilities in children, lower productivity, increased morbidity, and mortality and lower immune responses. India is home to an estimated third of the world’s micronutrient deficient individuals. Almost 70% of the Indian population receives less than half of the recommended daily nutritional intake.

According to a World Bank document, the country loses close to ₹ 90200 crore annually in GDP due to micronutrient deficiencies, whereas scaling up the micronutrient initiatives costs less than ₹ 4300 crores annually. Investing in food fortification is a cost-effective way to reduce malnutrition.

Data from the first phase of the National Family Health Survey-5, covering 17 states and five Union Territories, released in December last year, showed a worsening in indicators related to nutrition such as anaemia and Vitamin D levels in many states. There was an increase in child stunting in Goa, Kerala (increased from 19.7% to 23.4%) Telangana, Gujarat, and Maharashtra. Wasting became worse in states/UTs like Kerala, Ladakh, and others. In the proportion of underweight children, Kerala showed an increase from 16.1% to 19.7%. Telangana too displayed deterioration from 26.6% to 28.9%. Over half of children and women in 13 of the 22 States/UTs are anaemic and anaemia among pregnant women increased in half of the States/UTs compared to NFHS-4. In just three states, Telangana, Karnataka, and Kerala, the figures for children, women, and men, tell the story. In Telangana, the percentage of anaemic children increased from 60.7% to 70%. In Karnataka, the increase was from 60.9% to 65.5%, and from 35.7% to 39.4% in Kerala. In the case of women, for the same three states, the figures are: 56.6% to 57.6% (Telangana), 44.8%-47.8% (Karnataka) and 34.3%-36.3% (Kerala). In the case of men, while Telangana showed no change, Karnataka and Kerala showed a deterioration in indicators, with the percentage of anaemic men rising from 18.2%-19.6% and 11.7% to 17.8% respectively.

India’s Public Distribution System is largely grain-dependent (rice and wheat). These do not provide adequate protein and micronutrients such as Vitamin A and D, the absence of which can contribute to malnutrition and increased vulnerability to diseases. Many beneficiaries of the food programmes are too poor to buy protein-rich foods, leafy vegetables, and fruits that provide these micronutrients. Fortification is a proven, cost-effective scientific solution that can be scaled up.

Nutrition is a key focus area of the National Development Agenda (concerning the Global Sustainable Development Goals – SDGs. The Food Safety and Standards Authority of India (FSSAI) is framing policies and guidelines and is engaging with the food processing industry and food business operators (FBOs) for the fortification of cereals, oil, and milk with suitable micronutrients so that the fortified staples are easily available in the open market and to the state governments for distribution through the Public Distribution System (PDS), Integrated Child Development Services (ICDS) and the Mid-Day Meal (MDM) scheme.

Speaking of this Mr. Gururaj Patil, Team Lead, Fortification, KHPT said, “In India, the government has taken several measures to make food fortification a norm. The FSSAI has proposed to make retail edible oil and milk fortification mandatory across the country. Efforts are being made to provide quality assured fortified staples to all beneficiaries of social safety net programs. These efforts, if intensified and scaled up, have the potential to address the chronic micronutrient deficiencies plaguing large sections of the Indian population. The media can play the role of a catalyst, by building awareness about benefits of fortified food among the people and contributing to increased demand and consumption.”

The packaging of fortified products will carry a blue +F logo and the nutrition label on the packed product would indicate the various added micronutrients and their quantities, as specified by the FSSAI. Non-fortified products cannot use this logo.