Recently, FSSAI decided to mandate the fortification of rice and edible oils with vitamins and minerals. Through this, they plan to combat undernutrition in India. In response, a cohort of dissenting scientists, nutritionists, and activists signed and sent a letter to FSSAI.
Malnutrition in India
The National Family Health Survey (NFHS-5 2019-20) lists out some alarming facts. The prevalence of anaemia among children under the age of five has grown in 18 of the 22 states surveyed. According to the WHO, iron deficiency is the most common cause of anaemia. Deficiencies in folate, Vitamins A and B12 are also important causes.
Around 50% of women of childbearing age and 75% of children under the age of 5 are anaemic in India. A significant percentage of the population continues to suffer from malnutrition and anaemia, making India consider compulsory fortification of rice from 2024.
Experts singled out protein deficiency as a major issue in undernourished populations like India. This is a result of monotonous cereal-based diets and poor consumption of vegetables and animal source foods like meat, poultry, eggs, and fish.
Fortified foods have been made available to children through government schemes like the Mid Day Meal Scheme. This might seem substantial and life-changing for the undernourished. However, since nutrients also need other nutrients for absorption, the fortification of staple foods is not enough to combat undernourishment.
Fortification with one or two chemicals to address one nutrient deficiency will be limited by other nutrient deficiencies. This proposal for mandatory fortification citing RDA (Recommended Dietary Allowances) for micronutrients while not taking into account the shortfall in macronutrients of the population, is specious.
Mandatory fortification is not the answer
The letter warned of the adverse effects of such a policy, citing a study showing that vitamin A deficiency is over diagnosed. Therefore, mandating food fortification on a national scale would increase the risks of Hypervitaminosis in people. The camp opposing the Centre's decision makes a great case for why food fortification as a national policy may be the wrong path to take.
According to public health and nutrition experts, women who consume an excessive amount of iron can have negative effects on foetal development and birth outcomes, as well as adverse changes in the healthy microbiome and an increased risk of chronic diseases. “Since the intervention of iron or fortification is not monitored, no evidence on its benefit or safety is generated; such a policy is not justified.”
Mass-scale food fortification has piqued the interest of researchers. The study "Perspective: When the cure might become the malady", says that the prevalence of anemia is magnified because of inappropriate hemoglobin cutoffs, often used to diagnose the malady in children and pregnant women.
The study also states, in no uncertain terms, that the intervention of food fortification is "wasteful, ineffective, and potentially harmful" to human health. The research paper emphasizes that micronutrients are beneficial in the right dose, but potentially harmful when ingested in excess.
The real reason behind food fortification
It must be noted, as was also pointed out in the letter written to FSSAI, that there is a big conflict of interest at play here. Major companies like Nestle Nutrition Institute and the Global Alliance for Improved Nutrition have funded the studies backing the decision and stand to benefit from it.
Mandatory fortification of food can lead to cartelisation, as was the case in the EU. The government had to step in and punish these cartels who drove up the prices of foods. On a global scale, five multinational companies stand to profit from mandatory fortification of food in India. Namely - Germany’s BASF, Switzerland’s Lonza, France’s Adisseo, and Netherlands’ Royal DSM and ADM. These are the companies that supply micronutrients to all Indian suppliers.
Signatories pointed out that the mandatory fortification is detrimental to health, and it would bring socio-economic impacts such as the market shifts in favour of large corporations, loss of livelihoods for small and informal players, monocultures in diets, and dependence on packaged foods.
The letter further pressed that this move would lead to the financial crippling of small and local producer economies. The implementation of this decision on a large scale is sure to set off protests across our nation, so the question that needs to be asked is - How can we feed the hungry sustainably?
The way forward
The answer to this puzzle lies in consuming real food which is free of processing. It is a well-known fact that processing food leads to severe degradation in the nutritional content of food. Chemical processing makes these foods more profitable at the cost of our health. Consumption of these food items puts us at risk of heart disease and obesity. Thus processed food is far inferior to natural food. It is outright unhealthy to consume.
Therefore, FSSAI should direct its funds towards promoting natural food consumption. Clean food items that do not go through processing are brimming with essential nutrients and micronutrients. They also cost less in the long run due to the minimization of medical costs. Further, eating clean also helps support local farmers.
FSSAI has the power to govern the food processing industry through the rules it creates. It must not make the rules that benefit big food companies. Instead, it must promote healthy eating habits and the welfare of micro-entrepreneurs involved in the food supply chain. Processed food is artificial and is not the best solution to undernutrition. We must turn to the consumption of natural food for our own sake.