When it comes to nutrition, more specifically micronutrient malnutritionespecially given India’s diverse population, there is an urgent need to address the ailments that malnutrition can affect the masses.
Malnutrition is exacerbating the public health crisis we face and is India’s most serious challenge and concern. According to data from the National Family Health Survey-5, 1 in 2 of her Indian women are anemic, 1 in 3 of her children are stunted and malnourished, and 5 In person her one child is wasted. According to FAO’s 2021 Food Security Report, India ranks 101st out of 116 countries in the 2021 World Hunger Index, with 15.3% of the population undernourished and the highest proportion of stunted children. high (30%), with the highest proportion of wasted children (17.3%).
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The situation portrayed by the Global Nutrition Report 2021 is cause for concern, noting that stunting among children in India is significantly higher than the Asian average of 21.8%.
Since the 1920s, developed and high-income countries have successfully tackled malnutrition through fortification. Recently, lower and middle-income countries such as India have pursued food fortification as one of the strategies to address micronutrient malnutrition. Simply put, fortification is the process of adding nutrients to food. For example, rice and wheat are fortified with iron, folic acid and B vitamins. 12, and salts enriched with iron and iodine. Iodized salt has been used for decades.
Rice program and anemia
Pilot projects for fortified rice distribution have been taken up in some states, including Maharashtra (Gachiroli District), as part of targeted public distribution programs for the masses. The program has been successful in that he prevented cases of anemia from 58.9% to 29.5% within two years, and the central government has decided to increase the distribution of fortified rice, the staple food for his 65 people. Now declare an expansion. % of the population through existing platforms of social safety nets such as PDS, ICDS and PM-POSHAN.
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Various state experiences with fortified rice projects so far are consistent with results from global programs using fortified foods as a cost-effective strategy. The health benefits derived from food fortification have resulted in 80 countries enacting flour fortification legislation, 130 enacting iodized salt and 13 mandating rice fortification. Promising results of the pilot program in Gachiroli prompted proposals for a large-scale food fortification program, including fortified rice in all government safety net schemes. The study found a promising reduction (29.5%) in the combined prevalence of anemia among women, adolescent girls and children in the Gatchirori area.
Gujarat noon meal scheme
In Gujarat, as part of the Midday Meal Scheme, an 8-month study of rice interventions enriched with multiple micronutrients in school children (ages 6-12) in 2018-2019 found that hemoglobin concentrations increased, a 10% reduction in the prevalence of anemia and, more importantly, improved mean cognitive scores (11.3%).
According to the World Health Organization (WHO), iron deficiency anemia is a public health concern as it accounts for 3.6% of disability-adjusted life years or DALYs (years of life lost to early death and years lived with disability). A major concern. i.e. 47 million DALY lost or healthy life expectancy lost due to illness, disability or premature death (2016).
According to NITI Aayog (based on WHO meta-analysis on impacts of rice fortification), a rice fortification budget of around Rs 2,800 per year could save 35% of the total or 16.6 million DALYs per year without any known toxicity risks. In India, the cost of one DALY lost due to iron deficiency anemia (IDA) is about INR 30,000 while the cost of avoiding his DALY related to IDA is only INR 1,545, with a cost-benefit ratio of It will be 1:18. Fortifying rice at a cost of less than 1% of food subsidies in 2018-2019 could prevent 94.1 million cases of anemia, saving him Rs 809.8 crore in five years.
be careful
Despite the program’s proven effectiveness, activists express concern that excessive iron overdose from fortified rice is dangerous for people in the Jharkhand tribe who suffer from sickle cell anemia and thalassemia. doing. Fortified rice has iron levels of 28 mg to 42.5 mg, folic acid levels of 75 mcg to 125 mcg, and B vitamins. 12 Levels from 0.75 mcg to 1.2 mcg (FSSAI criteria). Considering the per capita intake, when a family of three consumes about 60 grams of rice per person for her, the additional intake of iron is 2.45 mg for him. In fact, it makes up for the daily iron loss from the body of 1 mg to 2 mg per day.
According to nutrition stalwarts, food fortification is a cost-effective and complementary strategy for addressing multiple micronutrient deficiencies. Food can help reduce micronutrient deficiencies and address overall health benefits.
Sirimavo Nair is Senior Professor, Department of Food and Nutrition, Maharaja Sayajirao University, Baroda, Gujarat.
