Opinion: Fortification of food with micronutrients: Building on the success of Universal Salt IodizationOctober 21 is marked as World Iodine Deficiency Day

New Delhi: Global Iodine Deficiency Disorders (IDD) Prevention Day is observed on 21st October to draw attention to sustaining the success of universal salt iodization (USI) which has eliminated afflictions due to iodine deficiency. The National Family Health Survey 2015-16 and the Comprehensive National Nutrition Survey (CNNS) 2019, reveal that over 95% population consume salt fortified with iodine providing iodine adequacy. No child in India is reported to be born crein suffering from preventable brain damage drop 10-15 IQ points or perform poorly at school due to iodine deficiency. The success of salt fortification is a great example of addressing a public health problem of micronutrient deficiency through strong public-private partnership of food industry and the entire trade chain including wholesalers and retailers.

Also Read: World Iodine Deficiency Day 2020: Understanding The Importance of Iodine For The Body

The positive lessons emerging from the USI experience pave the way for addressing hidden hunger or micronutrient deficiency. As per the CNNS, besides iron, deficiencies of folic acid, vitamins B12, A and D are high even in school children aged 5-9 years and adolescents aged 10-19 years. Almost a fifth suffer from vitamin A and D deficiencies while 3-4 out of 10 adolescents suffer B12 and folate deficiencies. These are important causes of mortality, morbidity, reduced immunity, impaired cognitive development, poor physical growth, poor mental concentration, and decreased work productivity.

Folic acid deficiency in fact, contributes to preventable neurological disorders in newborns while deficiency of folate along with iron and B12 leads to anaemia. Anaemia problem is grave in our country. Every second woman and child and every third man are anaemic. These micronutrients are not produced in the body and need to be obtained through regular consumption of pharmaceutical supplements or through ensuring adequate daily consumption of vegetables and fruits. In India, every second person consumes less than half the recommended dietary allowance (RDA) of these micronutrients, which is the primary reason for such deficiencies.

The long-term solution to this ‘hidden hunger’ problem, is being intensified under the POSHAN Abhiyaan. Establishment of ‘saag-sabjee bagichaas’ (kitchen gardens) is being promoted at home level, schools and ICDS. The National Agri-Food Biotechnology Institute scientists are also working on biofortification measures for enhancing the micronutrient content of selected food items such as bananas. Food fortification is the other doable diet-based cost-effective solution to reach the unreached, as demonstrated by the success of USI.

Also Read: In 2020, Lives and Livelihoods Of Up To 270 Million People Will Be Under Severe Threat: WFP’s Cost Of A Plate Of Food 2020 Report

Food fortification, a measure complementary to diet diversification and supplementation, is gaining increased attention in India. The Food Safety and Standards Authority of India (FSSAI), issued guidelines on fortifying wheat flour and rice with iron, vitamin B12 and folate, fortifying edible oil and milk with vitamins A and D and double fortification of salt with both iron and iodine. The fortification technology ensures fortificant levels are safe and free from any toxicity, with minimum cost escalation and no change in colour, taste, or texture.

Recognizing the urgency to eliminate micronutrient deficiencies in vulnerable population reached through ICDS and MDM, the Ministry of Women and Child Development and the Ministry of Human Resource Development issued instructions in mid-2017 for mandatory use of fortified wheat flour, rice, oil and double fortified salt in the social safety net feeding programmes. Additionally, the Ministry of Consumer Affairs, Food and Public Distribution issued guidelines to state governments in December 2016 to consider supplying fortified wheat flour under PDS.

Besides government programmes, taking into consideration its immense benefits, the scope of using only fortified food staples in institutional set-ups such as large canteens of industries need to be explored. Interestingly, some tea industries that make partial payment as food rations have shifted to supplying fortified foods since the value-addition of micronutrient adequacy in reducing anaemia, absenteeism, lethargy and enhancing overall productivity is well-recognized.

Also Read: Poshan Maah 2020: Why Protecting Health And Nutrition Rights Of Children During COVID-19 Is Important For India, Experts Speak

Elimination of micronutrient deficiencies through food fortification would be achieved only when industry and government are treated as equal partners and voluntary sale of fortified food items through open market is enhanced with the full support of food industries and their national and regional associations, wholesalers, and retailers. Moreover, mainstreaming the unorganized sector in the food fortification efforts remains a challenge. Lessons can be learnt from salt industry to involve them since about one-third of wheat flour is marketed by organized producers. Such a production scenario also does not support the policy of making fortification mandatory, except in the case of oil since the unorganized sector has only 3-5% edible oil. The policy of mandating oil fortification therefore needs serious consideration.. Along with these, demand creating strategy for consumers is imperative..

To facilitate wise food choices and purchase of fortified wheat, rice, oils and milk, FSSAI has issued ‘+F’ logo, denoting fortification. The logo needs to accompany information on fortification benefits such as enhanced mental concentration, school performance, immunity, productivity, work output and earning capacity. Wide dissemination of this information can create consumer demand. The success of iodized salt’s ‘Smiling Sun’ logo testifies the significance of such a strategy. Moreover, for sustaining quality of fortified food items, higher attention needs to be directed to establishing an appropriate government-controlled monitoring system for traders and consumers at state level. Introduction of a simple consumer-friendly micronutrient testing kit, as in the case of India developed and manufactured rapid iodized salt testing kit (MBI Kits, Chennai), is essential not only for protecting consumer interest but also for building confidence among consumers for investing in the purchase and consumption of adequately fortified food for building human capital.


Fortification of food with micronutrients: Building on the success of Universal Salt Iodization

 

 

(The author is Dr Sheila C. Vir, Founder Director, Public Health Nutrition and Development Centre. Views expressed are personal)

 

 

 

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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