Temporary measure of food fortification to fight against malnutrition: Director of ICMR-NIN Dr Hemalatha R

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ICMR National Institute of Nutrition Director Dr Hemalatha R said food fortification should be seen as a temporary measure to address the problem of malnutrition until approaches to long term more upstream are achieved.

She noted that the fortification program is designed to bridge the gap between actual intakes and requirements for a particular nutrient.

His remarks add to some concerns raised by experts that fortified foods cannot be considered a replacement for a diverse and well-balanced diet.

The government plans to strengthen the rice distributed to the poor through various programs such as midday meals in order to fight against malnutrition.

Prime Minister Narendra Modi recently announced that, whether through ration shops or the Midday Meal (MDM) program, the rice made available under each government program would be fortified by 2024.

The director of the Indian Council of Medical Research and the National Institute of Nutrition said micronutrient deficiency is mainly due to inadequate dietary intake, poor food quality and lack of minimum dietary diversity.

“Fortification of foods with one or more micronutrients of public health importance is considered one of the practical approaches by policy makers and implementing agencies, as it does not require behavior modification, which is difficult to achieve in all population groups, ”Hemalatha told PTI.

She said efficacy studies such as randomized controlled trials (RCTs) using iron-fortified rice conducted as part of the MDM (supervised feeding) program improved children’s iron stores and reduced anemia.

“However, supervised feeding and deworming, even without fortified rice, also improved hemoglobin levels and reduced anemia. The above results come from studies that have supervised the feeding schedule and therefore cannot be generalized. Efficacy trials on fortified rice under field conditions have not yet been conducted in India, therefore the benefits of rice fortification are not yet fully understood, ”said Hemalatha.

Responding to concerns that fortified foods cannot be treated as a substitute for a good quality diet, she said food fortification should be seen as a temporary measure until long-term approaches. upstream, such as food diversification, are achieved.

“Fortification programs are designed to bridge the gap between actual intake and the need for a particular nutrient. But a varied diet provides all the nutrients necessary for good health. A balanced diet that sources nutrients from at least eight food groups has the potential to provide all of the necessary nutrients. Fruits, vegetables, nuts and oilseeds can be excellent sources of vitamins, minerals and bioactive substances essential for health and immunity, ”she said.

“Legumes, legumes, beans, peas as well as poultry, meat and preferably fish are important sources of essential fatty acids and essential amino acids for immunity and to fight against deficiencies in micronutrients. In addition, milk or curd is not only rich in quality protein but also in calcium and essential fats. Likewise, whole grains, cereals and millets are important sources of energy, protein, fiber and other nutrients, ”added the director of the National Institute of Nutrition.

Elaborating on how rice fortification is done, she said Fortified Rice Kernels (FRK) are produced by a hot or cold extrusion process and the target nutrients, along with other stabilizing ingredients , are added to the rice flour, transformed into a dough by preconditioning. process, extruded in twin screw extruders using a die with rice shaped inserts and dried on drying belts.

The level of fortifiers in FRKs should meet the standards of the national regulatory body. This FRK is mixed with natural rice to prepare fortified rice based on scientific evidence of people’s dietary needs. Usually the appropriate ratio is 1: 100; that’s one grain of fortified rice per 100 normal unfortified rice, said Hemalatha.

Experts said that fortified rice cannot be seen as a replacement for a diverse and well-balanced diet, but should be seen as a complementary food to the daily diet to fill the nutrient gaps seen in the Indian diet. consumed by the masses.

Dr Sheila Vir, director of the Public Health Nutrition and Development Center, said that a diverse diet that includes foods from at least eight food groups was not readily available to all, with interventions such as food fortification basic ingredients help to improve nutritional quality. of food and help improve the nutritional security of men, women, adolescents and children in the country.

“Rice, a staple grain of 65% of Indians, is devoid of nutrients such as vitamin B12 and other processes such as grinding and polishing lead to a loss of iron and folic acid content. Adding these micronutrients to rice during fortification at levels that provide 30 to 50 percent of the recommended daily nutrient allowance will improve the nutritional quality of the diet which is otherwise not available, ”she said. at PTI.

Vir added that with the on-going development in rice fortification, special attention would be needed to develop strong quality assurance and quality control systems and oversight mechanisms to ensure that product quality is maintained throughout the supply chain and beneficiaries get the most benefit from it.

Sakshi Jain, National Food Fortification Program Manager for India, Nutrition International, said one of the most effective, scalable, affordable and sustainable ways to address micronutrient deficiencies among vulnerable populations is to distribute staple foods fortified through social safety net programs.

The Prime Minister’s recent announcement on the fortification of all rice supplied through the public distribution system by 2024 will require synthesis efforts from all stakeholders, from rice producers, millers, quality controllers and managers. policy makers to convert the important, Jain said.


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