Adverse Impact of food fortification with multiple micronutrients

Context: In a pushback against the Centre’s plan to mandatorily fortify rice and edible oils with vitamins and minerals, a group of scientists and activists have warned of the adverse impacts on health and livelihoods.
Issue

• In order to fight chronic anaemia and undernutrition, the government is making plans to distribute fortified rice through the Integrated Child Development Services and Mid Day Meal Schemes across the country from the year 2021, with special focus on Aspirational districts.
• But group of scientists and activists have warned the Food Safety and Standards Authority of India (FSSAI) of the adverse impacts of Food Fortification on health and livelihoods.

About Food Fortification

• Food fortification is defined as the practice of adding vitamins and minerals to commonly consumed foods during processing to increase their nutritional value.
• It is a proven, safe and cost-effective strategy for improving diets and for the prevention and control of micronutrient deficiencies.

Types of food fortification
Food fortification can also be categorized according to the stage of addition:

• Commercial and industrial fortification (wheat flour, cornmeal, cooking oils)
• Biofortification (breeding crops to increase their nutritional value, which can include both conventional selective breeding, and genetic engineering)
• Home fortification (example: vitamin D drops)

Advantages offered

• Health: Fortified staple foods will contain natural or near-natural levels of micro-nutrients, which may not necessarily be the case with supplements.
• Taste: It provides nutrition without any change in the characteristics of food or the course of our meals.
• Nutrition: If consumed on a regular and frequent basis, fortified foods will maintain body stores of nutrients more efficiently and more effectively than will intermittently supplement.
• Economy: The overall costs of fortification are extremely low; the price increase is approximately 1 to 2 percent of the total food value.
• Society: It upholds everyone’s right to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger

Issues with fortified food

• Against nature: Fortification and enrichment upset nature’s packaging. Our body does not absorb individual nutrients added to processed foods as efficiently compared to nutrients naturally occurring.
• Bioavailability: Supplements added to foods are less bioavailable. Bioavailability refers to the proportion of a nutrient your body is able to absorb and use.
• Immunity issues: They lack immune-boosting substances.
• Over-nutrition: Fortified foods and supplements can pose specific risks for people who are taking prescription medications, including decreased absorption of other micro-nutrients, treatment failure, and increased mortality risk.
• Decrease Value of Natural Food: Dietary diversity was a healthier and more cost-effective way to fight malnutrition. For example Once iron-fortified rice is sold as the remedy to anaemia, the value and the choice of naturally iron-rich foods like millets, varieties of green leafy vegetables, flesh foods, liver, to name a few, will have been suppressed by a policy of silence.

Government Interventions
FSSAI Regulations

• 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.

Nutritional Strategy

• India’s National Nutritional strategy, 2017, had listed food fortification as one of the interventions to address anaemia, vitamin A and iodine deficiencies apart from supplementation and dietary diversification.

Milk Fortification Project

• The Milk Fortification Project was launched by the National Dairy Development Board (NDDB) in collaboration with the World Bank and Tata Trusts, as a pilot project in 2017.