Food Fortification

IN NEWS:

• As many as 269 districts in 27 states have started distributing fortified rice under the Targeted Public Distribution System (TPDS), achieving the 100% target set for Phase II by March 2023 in the Rice Fortification Programme. Now, under the third phase, the Centre is gearing up to complete the coverage of all remaining districts, excluding wheat-consuming ones, before the targeted date of March 2024.
• The Centre had decided to supply fortified rice in every social safety net scheme of the Centre throughout the country by 2024 in a phased manner.

WHAT IS FOOD FORTIFICATION?

• The Food Safety and Standards Authority of India (FSSAI) defines fortification as “deliberately increasing the content of essential micronutrients in a food so as to improve the nutritional quality of food and to provide public health benefit with minimal risk to health”.
• Food fortification can be categorized according to the stage of addition:
  • Commercial/industrial fortification
  • Biofortification: breeding crops to increase their nutritional value, through conventional selective breeding and genetic engineering.
  • Home fortification (Eg: Adding vitamin D drops)
• Fortification is an evidence-informed intervention that contributes to the prevention, reduction and control of micronutrient deficiencies.
• It can be used to correct a demonstrated micronutrient deficiency in the general population (mass or large-scale fortification) or in specific population groups (targeted fortification) such as children, pregnant women and the beneficiaries of social protection programmes.
• In India, food fortification began in the 1950s with vegetable oil fortification and salt iodization. In the 2000s, the government introduced fortification of other commodities such as rice and wheat.
• In 2016, FSSAI established standards for fortification of rice, wheat flour, edible oil, double fortified salt (DFS), and milk.
• The ‘+F’ logo has been notified to identify fortified foods.
• In January, 2021, the FSSAI had issued draft regulations on mandatory fortification of edible oil and milk with vitamin A and D.

Examples:

• Iodised salt: Salt that contains small amounts of sodium iodide or potassium iodide; used for boosting thyroid function.
• DRR Dhan 45: High zinc variety of rice, developed by the Indian Institute of Rice Research (IIIR).
• MACS 4028: biofortified, high protein wheat variety developed by Agharkar Research Institute (ARI), Pune.
• Madhuban Gajar: Biofortified carrot developed by Vallabhhai Vasrambhai Marvaniya, a farmer scientist from Junagadh district, Gujarat.

SIGNIFICANCE OF FORTIFICATION:

• Reduce ‘hidden hunger’:
  • In India, over 80% adolescents suffer from hidden hunger, according to UNICEF’s 2019 report. Fortification can help reduce this deficiency and promote nutritional security in the country.
• Address nutritional imbalance:
  • According to NFHS 4, over 70% of the population consumes less than half the daily recommended dietary allowance of micronutrients a day. One key reason for this is the monotonous cereal-based diets with low consumption of vegetables and protein.
• Enhance maternal & child health: 
  • India is home to one in three of the world’s malnourished children and has the second highest level of wasting among children globally. Women in India also have the highest prevalence of anemia globally. This contributes to high levels of maternal and infant mortality in India. Fortification can address this issue.
• Cost-Effective intervention:
  • Fortification adds only 3-7% to the retail price of food. Hence, for the end consumers, the affordability of fortified foods is not a significant barrier.
• No behavioural change is needed:
  • Fortification can make frequently consumed foods or daily staples more nutritious without any change in the dietary habits of the consumers.
• Overcome Covid-induced poverty:
  • Due to Covid-19, the nutritional status of people are likely to worsen as both the availability of food and the ability to pay for it become more sporadic. Supplying fortified staple foods can help address this issue to an extent.
• Natural or near natural ingredients:
  • Fortification generally aims to supply micronutrients in amounts that approximate to those provided by a good, well-balanced diet. Hence, fortified staple foods will contain natural or near natural levels of micronutrients.

GOVERNMENT INITIATIVES:

• Food Safety and Standards (Fortification of Foods) Regulations, 2016
  • 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.
  • The ‘+F’ logo has been notified to identify fortified foods.
• Centrally sponsored pilot scheme, ‘Fortification of Rice and its Distribution under PDS’
  • In 2019-20, the Ministry of Consumer Affairs, Food and Public Distribution launched a centrally sponsored pilot scheme, ‘Fortification of Rice and its Distribution under PDS’, for three years with a total budget outlay of Rs 174.64 crore.
  • The pilot scheme focuses on 15 districts in 15 states — Andhra Pradesh, Kerala, Karnataka, Maharashtra, Odisha, Gujarat, Uttar Pradesh, Assam, Tamil Nadu, Telangana, Punjab, Chhattisgarh, Jharkhand, Uttarakhand, and Madhya Pradesh.
• NAFED’s  Fortified Rice Bran Oil:
  • Rice Bran oil from Nafed will be fortified and it will be ensured that it will contain additional nutrients and vitamins.
  • According to the FSSAI, fortified oil can help a person fulfil 25-30% of the recommended dietary intake for vitamins A and D.

CONCERNS:

• Not a substitute to good nutrition:
  • Adding a few micronutrients is only a short-term solution to the larger issue of malnutrition. Dietary diversity and higher protein consumption are key to solving undernutrition in India.
• Unreliable studies:
  • Many of the studies which FSSAI relies on to promote fortification are sponsored by food companies who would benefit from it, leading to conflicts of interest.
• Possibility of toxicity:
  • Nutrients usually do not work in isolation, but need each other for optimal absorption. Adding one or two vitamins and minerals (like synthetic nutrients) will not solve the larger problem, and in an undernourished population like India’s, it may lead to toxicity.
  • Fortified rice leading to side effects:
    • Recently, a multidisciplinary fact-finding team of NGOs, after visiting a tribal belt in Jharkhand, where fortified rice is being given in a pilot project, has found that Iron-fortified rice distribution has shown adverse health impact among Adivasi populations suffering from sickle-cell anaemia and thalassemia.
• Accessibility for poor:
  • 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.
• Affects food MSMEs:
  • Mandatory fortification would harm the vast informal economy of Indian farmers and food processors including local oil and rice mills. This is because they will have to spend on machinery necessary for food fortification, such as blending machinery.
• Issue in production and distribution:
  • While the oil and salt industries are relatively consolidated with large players accounting for 40-90% of production, cereal industries are characterized by a vast number of small-scale informal producers. This makes dissemination, coordination, and capacity building very challenging.
• Fear of cartelization:
  • Just five corporations have derived most of the benefits of global fortification trends and these companies have historically engaged in cartelising behaviour leading to price hikes. This can happen in India as well.

WAY FORWARD:

• Improve public perception:
  • Large scale food fortification (LSFF) is a powerful way to tackle micronutrient malnutrition. But the common man needs to be brought on-board for the efforts to be successful. Hence, awareness measures are essential.  
• Independent research:
  • The FSSAI should take initiatives to generate unbiased independent research supporting fortification before major national policies are rolled out.
• Support for MSMEs:
  • Government needs to ensure that MSMEs are supported with subsidized loans and facilities for upgrading to food fortification. FSSAI should ensure that there is no cartelization in fortified food market. 
• Promote dietary diversity, healthy and sustainable food:
  • Dietary diversity along with healthy and sustainable food system is the healthier and more sustainable way to fight malnutrition. For this, existing measures like the public distribution system and mid-day meal scheme in India should provide diverse food choices such as nutri-cereals.
  • Eg. FSSAI has embarked on a large-scale effort to transform the country’s food system in order to ensure safe, healthy and sustainable food for all Indians through the ‘Eat Right India’ movement.

PRACTICE QUESTION:

Q. “Food fortification is a ‘complementary strategy’ rather than a ‘replacement of balanced, diversified diets’ to address malnutrition”. Discuss the statement with reference to the role of food fortification in addressing the issue of malnutrition in India?