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Is mandatory fortification of rice effective against malnutrition?.

Emphasising that malnutrition is a “hurdle” in the development of women and children, Prime Minister Narendra Modi 15 August 2021 announced fortification of rice distributed under various government schemes including Public Distribution System (PDS) and Mid-Day-Meal scheme by 2024. Addressing the nation from the Red Fort on the 75th Independence Day, Modi said, “Raashan kee dukaan par milane vaala chaaval ho, Mid-Day-Meal mein baalakon ko milane vaala chaaval ho, varsh 2024 tak har yojana ke maadhyam se milane vaala chaaval fortified kar diya jaayega. (Be it the rice distributed through ration shops or the rice provided to children in the mid-day meal, the rice available through every scheme will be fortified by the year 2024.)” The Prime Minister said it is the government’s priority to provide nutrition to every poor person of the country. “Malnutrition is a big hurdle in the development of women and children. In view of this, it has been decided to fortify the rice distributed under the different schemes…,” the Prime Minister said. The Food Safety and Standards Authority of India (FSSAI), that sets standards for food items in the country, defines the fortification as “deliberately increasing the content of essential micronutrients in a food so as to improve the nutritional quality of food and to provide public health benefit with minimal risk to health. According to the FSSAI norms1 kg fortified rice shall contain iron (28mg-42.5mg)folic acid (75-125 microgram) and Vitamin B-12 (0.75-1.25 microgram). In addition, rice may also be fortified with micronutrients, singly or in combination, at the level– zinc(10mg-15mg)Vitamin A (500-750 microgram RE)Vitamin B1 (1mg-1.5mg)Vitamin B2 (1.25mg-1.75mg)Vitamin B3 (12.5mg-20mg) and Vitamin B6 (1.5mg-2.5mg) per Kg. The announcement is significant as the government distributes over 300 lakh tonnes of rice under various schemes covered under the National Food Security Act, 2013. The Centre has allocated 328 lakh tonnes of rice for TPDSMDM and ICDS under NFSA during 2021-22. India accounts for over one-fifth of the world’s rice production. It is also the largest consumer of rice, with a per capita rice consumption of 6.8 kilograms per month. The Ministry of Consumer Affairs, Food and Public Distribution had launched a centrally sponsored pilot scheme on “Fortification of Rice and its Distribution under Public Distribution System (PDS)” for a period of three years beginning 2019-20 with a total budget outlay of Rs.174.64 crore. The pilot scheme focuses on 15 districts in 15 states– Andhra Pradesh, Kerala, Karnataka, Maharashtra, Odisha, Gujarat, Uttar Pradesh, Assam, Tamil Nadu, Telangana, Punjab, Chhattisgarh, Jharkhand, Uttarakhand and Madhya Pradesh. Under the scheme, the blending of rice is done at the milling stage. According to the Ministry, Maharashtra and Gujarat have started distribution of fortified rice under PDS in the Pilot Scheme from February, 2020. The Scheme is funded by the Government of India in the ratio of 90:10 in respect of North Eastern, hilly and island states and 75:25 in respect of the rest. In the union Budget 2021-22, Finance Minister Nirmala Sitharaman had announced Mission Poshan 2.0. “To strengthen nutritional content, delivery, outreach, and outcome, we will merge the Supplementary Nutrition Programme and the Poshan Abhiyan and launch the Mission Poshan 2.0,” she said in her budget speech. Fortifying rice involves grinding broken rice into powder, mixing it with nutrients, and then shaping it into rice-like kernels using an extrusion process. These fortified kernels are then mixed with normal rice in a 1:100 ratio and distributed for consumption. But the current national capacity of 15,000 tonnes of rice kernels a year is far from adequate. To cover the PDS, anganwadis and MMS in at least the 112 aspirational districts, the annual capacity has to be around 130,000 tonnes. To cover the PDS across the country, at least 350,000 tonnes of fortified kernels would be needed. The Food Corporation of India has been asked to invest in equipping rice mills with the blending machines needed to mix the kernels into normal rice. There are other challenges in meeting the 2024 deadline set by PM Modi. Rice millers will have to make the immediate investment and the government says it will consider offering loans and other incentives to create an enabling environment. Some of them are being lured with the promise of good returns on their investment. Since the fortified kernels look and taste the same as normal rice grains, there is also an urgent need for quality control testing and monitoring to ensure consumers are not taken for a ride. FSSAI and the NABL laboratories are exploring avenues to build capacity for quality testing. The biggest challenge, though, will be creating awareness about the benefits of fortified foods to ensure uptake. Meanwhile, opinion is divided on the efficacy and value of consuming fortified rice. The basic purpose of food fortification is to improve the nutritional quality and provide public health benefits to the population with minimal risks. But there is the need to use food additives in permitted quantities to make it palatable. The technological process also increases costs. “Mandatory fortification of rice would certainly pose a risk to food safety despite the safeguards of food laws. The implementation of food safety laws, mainly left to state governments and Union territories now, will be a big problem since the implementation machinery in many states is weak,” explains international food safety specialist Dr Ramesh V. Bhat. “Fortification of rice to combat anaemia and malnutrition is very different from the fortification of salt with iodine campaign, which was primarily meant to combat goitre in the hill tracts. It later went all-India with the double fortification of salt.”
Addition of basic material like ferric pyrophosphate and enhancing compounds like citric acid and trisodium citrate mixtures to increase iron absorption in a staple food is the most common form of fortification. Rice is consumed in large quantities as a staple in India and mandatory fortification will force even the population groups which do not need it into taking additional food additives.
Advocates of fortification generally take into account only a food of their choice. Instead, total dietary intake of food from a variety of sources ranging from natural foods to technologically processed foods (including ready-to-eat food) needs to be taken into account. Also, the interests of the whole population must be taken into account rather than only the vulnerable segments who may really be needing only additional minerals and vitamins. A range of natural foods such as locally available leafy green vegetables and local fruits, like a variety of berries, available naturally in tribal and rural areas would provide the required nutrients to the local population. Those against food fortification argue that increasing the availability of such foods and popularising them through nutrition education would benefit society.
“Food fortification is a good move but it has a long way to go before we see visible results. But it does send the right signals for a food-based approach to fortification in India. It will happen in phases beginning with the PDS,” emphasises Dr V. Prakash, president, International Union of Food Science and Technology, and a former director of the Central Food Technology Research Institute, Mysuru. “Rice, being a staple food in many parts of India, is consumed in reasonably good quantity and will provide the needed micronutrients on a daily basis along with the other foods it is eaten with. This hopefully will be supplemented with enough proteins and other needed macro and micronutrients." Other analysts point out that fortifying one or two nutrients is not the solution when the problem of sufficient quality protein to children and convalescent is still a major concern. Unless all segments are addressed in one go, under-nutrition and malnutrition will continue. Several questions raised by those sceptical of food fortification are yet to be answered. These include: how much fortification will fill the gap?; isn’t nutrition a daily dose issue; how can it be treated like a vaccine?; social and cultural practices dictate the extensive washing of pulses and rice; can that be stopped with fortified rice?; what is the cost of fortification?; how does one monitor the improvement in health in different segments of the population?; mid-day meals for children and increasing its nutrition profile of proteins and calories is vital, when will we address them? Analysts argue that there is need for extreme caution in implementing food fortification to address micronutrient deficiencies in India. Attention must even be paid to the consequences of excess intake when such schemes are offered along with food supplements. A recent study makes a case for improving dietary diversity instead.






POSTED ON 24-09-2021 BY ADMIN
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