In the recently formulated National Health Policy, the Government acknowledged fortification as a key strategy to address micronutrient deficiencies in India. Food fortification should be a vital element of health programmes. Oil is widely consumed by all population groups in India, thus it can be a potent vehicle for fortification with vitamin A and vitamin D
Primarily caused by dietary deficiencies of vitamins A and D, micronutrient malnutrition is emerging as a silent epidemic. Commonly called “hidden hunger”, it does not create hunger pangs but strikes at the core of growth and development. It is a global phenomenon affecting infants, young children and adults of all ages. More than 2 billion people in the world today are affected by micronutrient malnutrition.
Micronutrient malnutrition contributes greatly to the global burden of diseases and is more severe in developing countries. Although India has made significant strides in healthcare in the last decade, it still has a high prevalence of malnutrition, which impedes the socio-economic development. More than 57 per cent of children suffer from Vitamin A deficiency and the prevalence of Vitamin D deficiency is as high as 70 per cent in some areas, hence making it more difficult to tackle, but all the more urgent to address.
Micronutrients are dietary components which are vital to development, disease prevention and the well-being of all. Its deficiencies can have far reaching and devastating consequences. Micronutrient deficiencies not only lead to cognitive impairment and increased incidence and severity of infectious illness, but also have far reaching effects on economies through physical and mental disabilities as well as reduced immunity and work productivity, perpetuating poverty and deprivation among people. It also increases mortality and morbidity rates among vulnerable groups. It is estimated that the short-term economic cost of micronutrient malnutrition in India amounts to 0.8 per cent to 2.5 per cent of the gross domestic product.
Although these deficiencies are not physically visible, they are widespread. The Indian Constitution guarantees its citizens the fundamental Right to Life which includes the right to adequate food, shelter and clothing. The very existence of malnutrition and hunger is violation of the Constitution and the Right to Life. Our goal should be to end hunger and malnutrition in all its forms.
There are various approaches to dealing with micronutrient malnutrition. According to the World Bank, food fortification is one of the simplest, proven, cost-effective complementary strategies. Food fortification aims at addition of essential micronutrients like vitamins and minerals into daily consumed food items. In the case of vitamin A and D, these fat-soluble vitamins can easily be introduced into Indian vegetarian diets through the means of oil fortification, milk and non-dairy soy milk fortification, providing the masses easier access to essential micronutrients and helping in fighting vitamin A and D deficiency-related diseases.
Along with timely intervention of this strategy it is very important to make policymakers, caregivers and families aware of the need for food fortification. While this alone cannot address micronutrient deficiencies, it is definitely one of the critical strategies to address micronutrient deficiencies. In India, food fortification efforts have been scattered and there needs to be a clear strategy from the Government to promote large-scale fortification of food. New investments are needed to build, improve and sustain fortification programmes across the country to reduce the prevalence of diseases caused by nutritional deficiencies.
As a step in this direction, I am glad to note that in the recently formulated National Health Policy, the Government acknowledged fortification as a key strategy to address micronutrient deficiencies in India. Food fortification should be a vital element of health programmes both at the national and State level and needs to be scaled-up at all levels.
In an effort to address the issue, last year, food regulatory body, Food Safety and Standards Authority of India (FSSAI), released a set of standards for fortification of various food items such as rice, wheat flour, salt, milk and oil. Oil is widely consumed by all population groups in India, thus it can be a potent vehicle for fortification with fat soluble vitamins — vitamin A and D. Also the process involved is simple, cost-effective and affordable. Some States in India, like Madhya Pradesh, Haryana and Himachal Pradesh, have already begun fortifying oil for their welfare schemes like mid-day meals. The Gujarat and Rajasthan Governments are early adopters and have taken a huge leap in fortification by selling fortified oil in the entire State to address micronutrient deficiencies. It is high time other States followed suit. Micronutrient interventions are critical to achieve the nutrition targets of Sustainable Development Goals. Our investments towards other interventions will have a greater impact on health outcomes of our country if we are successful in tackling nutritional deficiencies.
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