Food fortification

Food fortification is defined as the practice of deliberately increasing the content of an essential micronutrient, i.e. vitamins and minerals (including trace elements) in a food, to improve the nutritional quality of the food supply and to provide a public health benefit with minimal risk to health.
It is a cost-effective strategy for improving diets and for the prevention and control of micronutrient deficiencies.
It can be carried out by food manufacturers, or by governments as a public health policy which aims to reduce the number of people with dietary deficiencies within a population.
In 2008 and 2012, the Copenhagen Consensus ranked food fortification as one of the most cost-effective development priorities.
- The Copenhagen Consensus Center provides information on which targets will do the most social good relative to their costs

70% of people in India do not consume enough micronutrients such as vitamins and minerals.
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) are the most common congenital malformation with an incidence that varies between 0.5-8/1000 births.
- It is estimated that 50-70% of these birth defects are preventable. One of the major causes is deficiency of Folic Acid.
58.4% of children (6-59 months) are anaemic
53.1% women in the reproductive age group are anaemic
35.7% of children under 5 are underweight
Deficiency of micronutrients or micronutrient malnutrition, also known as “hidden hunger”, is a serious health risk.
Unfortunately, those who are economically disadvantaged do not have access to safe and nutritious food. Others either do not consume a balanced diet or lack variety in the diet because of which they do not get adequate micronutrients.
Often, there is considerable loss of nutrients during the processing of food. One of the strategies to address this problem is fortification of food.

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.
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.
It does not alter the characteristics of the food—the taste, the feel, the look.
It can be implemented quickly as well as show results in improvement of health in a relatively short period of time.
This method is cost-effective especially if advantage is taken of the existing technology and delivery platforms.
The Copenhagen Consensus estimates that every 1 Rupee spent on fortification results in 9 Rupees in benefits to the economy. It requires an initial investment to purchase both the equipment and the vitamin and mineral premix, but overall costs of fortification are extremely low. 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.

Food Fortification

Distribution of fortified rice through the Integrated Child Development Services and Mid Day Meal Scheme.
The Milk Fortification Project – a collaborative initiative of the World Bank, Tata Trusts and National Dairy Development Board (NDDB) to address vitamin deficiencies in the consumers.
Poshan Maah to ensure community mobilisation and bolster people’s participation for addressing malnutrition amongst young children, and women and to ensure health and nutrition for everyone. It is Government of India’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
To reduce the high burden of micronutrient malnutrition in India, the Food Safety and Standards (Fortification of Foods) Regulations, 2016 were enacted to fortify staples such as 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).
The National Nutritional Strategy of 2017 included food fortification as one of the measures to address anaemia, vitamin A, and iodine deficits.

Group of scientists and activists have written to the Food Safety and Standards Authority of India (FSSAI), warning of the adverse impacts of food fortification on health and livelihoods.

Scientists have cited multiple studies to show that dietary diversity and higher protein consumption are key to solving undernutrition in India, rather than adding a few synthetic micronutrients which could harm the health of consumers.
Recent studies published in the medical journal Lancet and in the American Journal of Clinical Nutrition showed that both anaemia and Vitamin A deficiencies are overdiagnosed, meaning that mandatory fortification could lead to hypervitaminosis.
It also notes that 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.
One major problem with chemical fortification of foods is that 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.
High expense– The fortification cost the government Rs 3000 crores per year.

Rice bran, a rich source of numerous micronutrients, would reach people if less processed or unpolished rice was included in the public distribution system.
Kitchen gardens: Organic kitchen gardens (growing of fruits and vegetables at the backyard of house by using kitchen waste water) produce fruits and vegetables that increase micronutrients.
Increasing the intake of animal-based foods and fruits. A variety of natural diets is required to provide the normal population’s micronutrient needs, according to the National Institute of Nutrition.
Farming practices like Amrut Krishi, Fukuoka’s “Natural Farming” -organic agricultural methods that would result in improved food nutrition.
- Amrut Krushi uses scientific methods (Natueco Farming Science) to figure out the maximum possible yield in a particular area with maximum nutrition
- “The Fukuoka Method” or “the natural way of farming” or “Do-Nothing Farming”-the system is based on the recognition of the complexity of living organisms that shape an ecosystem and deliberately exploiting it.
Breastfeeding with correct latching practises. It has the potential to have a significant influence on nutrition insufficiency in the first 1,000 days.

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