Fortified Food Is Not The Silver Bullet We Need

Context: After the success of fortification of salt with iodine campaign, GoI pledged to provide iron-fortified rice by 2024 to every household for reduction of micronutrient deficiency.

Food fortification in India: FSSAI report shows that

• 80 brands of edible oils (70% of packaged oil market) now come fortified with vitamin A and D.
• 55 milk brands (a third of the packaged milk sales) have been fortified so far.
• 12 wheat flour and two rice brands (amounting to 3.4 million tonnes of packaged cereals) are fortified with iron every year.
• At least 16 states and union territories are also supplying fortified rice via their food safety net program.

Benefits of food fortification

• Cost-efficient strategy to manage chronic deficiency such as anaemia (due to shortfall in iron, vitamin B12 & folic acid) & deliver key nutrients.
• Replenishment of key Nutrients: Eg Milk lost fat-soluble vitamins due to pasteurization which can be replenished through fortification.
• Feasibility: Even small-scale processors can carry out fortification.

Issues associated with mandatory food fortification

• Loss of dietary diversity: Fortification of food with a single nutrient pushes consumers to eat more of the same food.
• Uncertain health consequences: Serious health consequences may arise due to fortifying staples with iron as a human body has no means to release excess iron except through blood loss.
  • Higher risk of diabetes due to massive dose of iron from fortified food
  • Iron-fortified food increases the severity of infection in TB and malaria
  • Over emphasis on iron ignore the other mineral requirements such as calcium, coppers
• Scope for marketing gimmick: Excessive fortification push may lead junk food companies to whitewash products and fool consumers in the name of voluntary fortification such as
  • Vitamins added to sugar-loaded juices, milk shakes or breakfast cereals & flavoured milk.
  • Opaqueness while displaying vitamins level on packaged food
• Regulatory issues and confusion among public to achieve recommended diets due to reduced distinctions between foods, supplements, and drugs.
• Market issues: Big-food labels may dominate market forcing small processing units such as oil and flour mills out of business.
• Legal issues: Unorganized food processing sector (2.8 million small chakkis supply & 150,000 oilseed crushing units) may come on the verge of becoming illegal.
• Ethical issues: Mass fortification is similar to mass medication.
• Real cause of malnutrition remains unaddressed.

Way Forward: Food Fortification is just a techno-fix, implementation shall be done with enough caution

• Deficiency levels, existing supplementation programmes and ease of adding nutrients should be kept in mind while making food fortification mandatory.
• Prioritise sustainable solutions: Such as increasing diversity of food on an average person’s plate through local food sources.
  • Dietary rationalisation: Indian families are consuming calorie-dense cereal products instead of recommended levels of pulses, legumes, milk, nuts and vegetables,\
• Creating awareness among households for inculcating healthy dietary practices.