Pros And Cons Of Food Fortification, An Effective Way To Address Micronutrient Deficiency

Pros And Cons Of Food Fortification, An Effective Way To Address Micronutrient Deficiency

National Nutrition Month 2020 India: Food fortification, the practise of adding vital micronutrients to staple foods is a cost-effective way to address micronutrient deficiency but there are some limitations to this strategy
Malnutrition, National Nutrition Month
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National Nutrition Month: Advantages And Disadvantages Of Food Fortification, An Effective Way To Address Micronutrient DeficiencyNutrition Month: Food fortification is the practice of deliberately increasing the content of an essential micronutrients
Highlights
  • Food fortification does not change the characteristics of the food
  • It is not a substitute for good quality diet required for optimal health
  • Dietary diversity is the key to address micronutrient malnutrition: Mr Kar

New Delhi: Malnutrition is the primary reason behind 69 per cent of deaths of children below the age of five in India, according to a UNICEF’s The State of the World’s Children 2019 report. The report further states that every second child in India, under five years of age, is affected by some form of malnutrition. According to Mini Varghese, Country Director, Nutrition International, conditions arising from malnutrition can prevent brain development, body growth, immune systems from working effectively, and increases lifelong risk of disease and disability.

Also Read: All About Food Fortification And How It Can Make India A Healthy Country

The control of micronutrient deficiencies is an essential part of the overall effort to fight hunger and malnutrition. India has been implementing a variety of strategies to address anaemia and micronutrient deficiencies which include iron-folic acid supplementation, vitamin A supplementation, nutrition health education to encourage dietary diversity, and others. However, the anaemia levels continue to be high. This, therefore, requires the introduction of strategies such as food fortification which are evidence based, tried and tested in other parts of the world, explained Bishow Parajuli, Country Director, World Food Programme.

The World Health Organization defines food fortification as the practice of deliberately increasing the content of an essential micronutrient (vitamins and minerals) in food so as to improve the nutritional quality of the food supply and to provide a public health benefit with minimal risk to health.

For example, adding iodine and iron to edible salt. Similarly, other vital micronutrients can be added to staples like rice, wheat flour, oil, and milk. The reason behind choosing staple items is to reach a larger population.

But is food fortification a good way of inculcating micronutrients in one’s diet and address the problem of malnutrition? Experts believe that just as there are two sides to coin, there are two sides to every strategy. In this report, we bring to you both pros and cons of fortified food.

Also Read: National Nutrition Month: Can India Piggy Bank On Food Fortification To Achieve The Goal Of POSHAN Abhiyaan?

Advantages Of Food Fortification

Does Not Require Behaviour Change

Fortification can make frequently consumed foods or daily staples more nutritious without any change in the dietary habits of the consumers. The demand and consumption of staples like wheat flour, rice, milk, oil, and salt usually remains uninterrupted in every scenario and they are consumed across the population – from low to high income groups. This makes food staples a great vehicle to add micronutrients to improve the nutritional status of the general population, said Ms Varghese.

Provides Nutrition Without Any Change In Characteristics Of Food

Though micronutrients are added, fortification does not cause any change in the taste, aroma, texture, or appearance of the food. For example, for the fortification of rice, Fortified Rice Kernels (FRK) are manufactured by combining rice flour with required nutrients. FRK resemble the sheen, transparency, consistency and flavour of rice. These kernels are simply mixed with ordinary rice.

Also Read: POSHAN Maah 2020: Three Different Ways Of Food Fortification Explained

Maintain Body Stores Of Nutrients

According to the ‘Guidelines on food fortification with micronutrients’ issued by the WHO and Food and Agricultural Organization of the United Nations, if consumed on a regular and frequent basis, fortified foods will maintain body stores of nutrients more efficiently and more effectively than will intermittent supplements.

Fortified foods are also better at lowering the risk of the multiple deficiencies that can result from seasonal deficits in the food supply or a poor quality diet. This is an important advantage to growing children who need a sustained supply of micronutrients for growth and development, and to women of fertile age who need to enter periods of pregnancy and lactation with adequate nutrient stores. Fortification can be an excellent way of increasing the content of vitamins in breast milk and thus reducing the need for supplementation in postpartum women and infants, states the guidelines.

Cost-Effective Intervention

The overall costs of fortification are extremely low; the price increase is approximately 1 to 2 per cent of the total food value.

Nutrition International and University of Toronto have developed the Encapsulated Ferrous Fumarate-Double Fortified Salt (EFF-DFS) which has both iron and iodine. According to Ms Varghese, the DFS comes with a minimal incremental cost of Rs. 0.02 per person per day.

Also Read: Akshaya Patra Foundation Is Improving Nutritional Quality Of Mid-day Meals Through Fortification

Contain Natural Or Near Natural Levels Of Micronutrients

According to the WHO, fortification generally aims to supply micronutrients in amounts that approximate to those provided by a good, well-balanced diet. Consequently, fortified staple foods will contain natural or near natural levels of micronutrients, which may not necessarily be the case with supplements.

Disadvantages Of Food Fortification

Not A Substitute Of Good Nutrition

While fortified foods contain increased amounts of selected micronutrients, they are not a substitute for a good quality diet that supplies adequate amounts of energy, protein, essential fats and other food constituents required for optimal health.

Also Read: How SuPoshan Sanginis Are Spreading The Idea Of Nutrition And Supporting POSHAN Abhiyaan

Might Not Benefit Infants And Children

For the first six months of the life, exclusive breastfeeding is recommended. A child will get nutrition only if the lactating mother will be healthy and consumes adequate nutrition. After the six months, complementary feeding is initiated, wherein infants and children consume relatively small amounts of food.

They are less likely to be able to obtain their recommended intakes of all micronutrients from universally fortified staples or condiments alone. Fortified complementary foods may be appropriate for these age groups, recommended WHO.

Fails To Cater To The Poorest Segment of The Population

Poorest segments of the general population have restricted access to fortified foods in the open markets due to low purchasing power and an underdeveloped distribution channel. To address this, Mr Parajuli suggests government food safety nets like public distribution system (PDS) to adopt staple food fortification strategies.

This will help ensure delivery of adequate nutrients to all sections of the population as is being encouraged in India, said Mr Parajuli.

Also Read: What Is NOVA Classification Of Food And How It Can Help In Making An Informed Choice?

Not A Long Term Solution

Basanta Kumar Kar recipient of the Global Nutrition Leadership Award believes that food fortification is a short and medium term measure. For long term sustainability, dietary diversity is the key to address micronutrient malnutrition.

In its guidelines, FSSAI (Food Safety and Standards Authority of India) has also titled food fortification as a ‘complementary strategy’ rather than a ‘replacement of balanced, diversified diets’ to address malnutrition. As explained by FSSAI, fortification only bridges the gap between the need and actual consumption of required micronutrients through food.

Can Have Detrimental Effects

‘Excess of anything is bad’. The old proverb is a guide for doing anything in moderation. According to Mr Kar, fortified foods as a public health measure should be promoted after analysing the efficacies and micronutrient status of the population. Excess dosages of vitamins and minerals in some cases can have harmful effects.

Also Read: Why Protecting Health And Nutrition Rights Of Children During COVID-19 Is Important For India, Experts Speak

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene.  

World

17,59,54,708Cases
5,81,66,715Active
11,39,84,189Recovered
38,03,804Deaths
Coronavirus has spread to 193 countries. The total confirmed cases worldwide are 17,59,54,708 and 38,03,804 have died; 5,81,66,715 are active cases and 11,39,84,189 have recovered as on June 14, 2021 at 3:36 am.

India

2,95,10,410 70,421Cases
9,73,15853,001Active
2,81,62,947 1,19,501Recovered
3,74,305 3,921Deaths
In India, there are 2,95,10,410 confirmed cases including 3,74,305 deaths. The number of active cases is 9,73,158 and 2,81,62,947 have recovered as on June 14, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

59,08,992 10,442

1,58,617 167

56,39,271 7,504

1,11,104 2,771

Karnataka

27,65,134 7,810

1,80,856 10,961

25,51,365 18,646

32,913 125

Kerala

27,28,239 11,584

1,23,433 6,478

25,93,625 17,856

11,181 206

Tamil Nadu

23,53,721 14,016

1,49,927 12,146

21,74,247 25,895

29,547 267

Andhra Pradesh

18,09,844 6,770

85,637 5,780

17,12,267 12,492

11,940 58

Uttar Pradesh

17,02,624 452

8,986 820

16,71,852 1,221

21,786 51

West Bengal

14,61,257 3,984

17,651 1,403

14,26,710 2,497

16,896 84

Delhi

14,31,139 255

3,466 144

14,02,850 376

24,823 23

Chhattisgarh

9,86,963 459

13,677 1,405

9,59,969 1,858

13,317 6

Rajasthan

9,49,684 308

7,441 959

9,33,421 1,260

8,822 7

Odisha

8,51,782 4,469

51,681 3,309

7,96,799 7,733

3,302 45

Gujarat

8,20,321 455

10,249 614

8,00,075 1,063

9,997 6

Madhya Pradesh

7,88,183 274

4,251 524

7,75,380 780

8,552 18

Haryana

7,65,861 339

4,661 525

7,52,208 821

8,992 43

Bihar

7,17,215 487

5,312 389

7,02,411 868

9,492 8

Telangana

6,03,369 1,280

21,137 996

5,78,748 2,261

3,484 15

Punjab

5,87,903 956

12,981 1,083

5,59,360 1,980

15,562 59

Assam

4,59,497 2,167

41,373 3,272

4,14,173 5,403

3,951 36

Jharkhand

3,43,458 154

3,395 571

3,34,979 723

5,084 2

Uttarakhand

3,36,879 263

4,633 388

3,25,311 644

6,935 7

Jammu And Kashmir

3,07,412 774

15,081 1,203

2,88,145 1,965

4,186 12

Himachal Pradesh

1,98,550 237

4,777 625

1,90,382 855

3,391 7

Goa

1,62,468 420

4,882 175

1,54,658 581

2,928 14

Puducherry

1,12,528 402

5,331 414

1,05,513 809

1,684 7

Chandigarh

61,110 54

520 20

59,798 71

792 3

Manipur

59,852 530

8,499 211

50,379 726

974 15

Tripura

59,321 235

5,170 382

53,531 610

620 7

Meghalaya

41,906 305

4,623 248

36,550 547

733 6

Arunachal Pradesh

31,282 134

2,885 302

28,252 434

145 2

Nagaland

23,644 82

3,502 131

19,689 208

453 5

Ladakh

19,561 17

658 88

18,706 105

197

Sikkim

18,414 157

3,553 230

14,580 387

281

Mizoram

15,364 97

3,549 111

11,748 203

67 5

Dadra And Nagar Haveli

10,463 1

78 17

10,381 18

4

Lakshadweep

9,209 34

576 39

8,589 72

44 1

Andaman And Nicobar Islands

7,261 18

110 11

7,025 29

126

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