From UPSC perspective, the following things are important :
Prelims level : Iron fortification
Mains level : Isuses with fortified food
Many things have been said about the necessity for mandatory iron fortification of foods in India.
- Iron fortification of food is a methodology utilized worldwide to address iron deficiency.
- A critical problem in some food fortification programs is the lack of bioavailability of iron compounds.
Why need iron fortification?
Ans. Prevalence of Anaemia
- Iron deficiency anaemia is due to insufficient iron.
- National Family Health Survey (NFHS)-5 provides insights into anaemia prevalence in the country, indicating that 57.2% of women ages 15 to 49 are anaemic, up from 49.7% in NFHS-4.
- Without enough iron, the body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin).
- Severe anemia during pregnancy increases your risk of premature birth, having a low birth weight baby and postpartum depression.
- Some studies also show an increased risk of infant death immediately before or after birth.
Concerns over iron fortification
Ans. Fear of diabetes and heart ailments
- Iron increases the risk for many non-communicable diseases like diabetes, hypertension and even high blood cholesterol.
- A US based survey shows that high ferritin level had a four-fold higher risk of having diabetes.
- The Comprehensive National Nutrition Survey of Indian adolescents to resulted in such scary outcomes.
- There was a clear and significant risk for each of these conditions as serum ferritin increased.
Ans. India is world capital of diabetes and hypertension
- No less than 50% of Indian children, aged 5-19 years, already had a biomarker of either high blood sugar or high blood lipids, even when thin or stunted.
- Thus, the risk of chronic disease is already very high in our children.
- Thus mandatory cereal fortification has severe hazards for India.
Why mandatory fortification is not a feasible option?
- Occurrence of deficiencies: We do not even know if anaemia is as rampant to warrant such mandatory measures.
- Manipulating food choices: When mandatory fortification is enforced in parts of the population that do not need this, it removes their choice of foods, or autonomy.
- Morbidities due to excess: It could even be unethical if the risk of other morbidities is increased.
- No successful example: Rice fortification has not been shown to work in a combined analysis.
- Food fortification is not a magic bullet.
- It should be viewed as a complementary strategy for the prevention and control of micronutrient deficiencies.
- As dietary patterns and deficiency states change, monitoring and periodic evaluation will be essential in helping to make necessary changes.