Rice fortification can help tackle our problem of hidden hunger
Summary
- Micronutrient deficiencies remain widespread in India but we can expect the government’s nutritional efforts to bear fruit
Micronutrient deficiency-induced malnutrition, commonly known as hidden hunger, results from insufficient intake or absorption of vitamins and other minerals. This condition remains concealed until clinical signs of deficiency become apparent, impeding optimal health and development in children and affecting normal physical and mental functions among adults. Hidden hunger can lead to severe consequences, including birth defects, impaired cognitive abilities, maternal and infant mortality, childhood blindness and reduced productivity. While balanced and diverse diets theoretically provide all necessary micronutrients for a healthy life, humans typically cannot produce these nutrients internally, except for vitamin D.
Though there has been a decline in hunger in India, the progress has been gradual, and the situation remains concerning when examined in terms of absolute numbers. According to a report by the Tata-Cornell Institute published in 2020, approximately 194 million people in the country were still undernourished during 2016-18, representing only a slight 8% decrease from the 210 million undernourished individuals in 1990-92.
In Aspirational Districts, as per the Social Progress Index (SPI) 2022, only about 12.32% of children aged 6-23 months receive adequate nutrition. Over 690 districts have less than 30% of children receiving proper nutrition and 17 districts have over half their children suffering stunting. Moreover, the prevalence of anaemia among women and children is 61.20% on average, while in 67 Aspirational Districts, less than 12% of children receive an adequate diet. Dietary habits also contribute to malnutrition and higher risks of chronic diseases, as India’s average daily calorie consumption falls below the recommended 2,503 kcal per capita per day. Whole grains contribute more to calorie intake, while fruits, vegetables, legumes, meat, fish and eggs are consumed in lower quantities. Inadequate protein intake is a concern, with only 6-8% of calories coming from protein sources. Further, a preference for processed foods over fruits and excessive cereal consumption compounds the issue.
To address hidden hunger, India has embraced food fortification as a strategic approach. These initiatives in India began in the 1950s with vegetable oil fortification and salt iodization. In the 2000s, the government introduced fortification of other staples like rice and wheat.
Food fortification goes back a long way. The practice of adding iodine to table salt to prevent goitre among schoolchildren began in Ohio, US, in 1920. The understanding of the role of micronutrient deficiency in diseases dates back to at least 1753, when James Lind conducted clinical trials on sailors aboard the HMS Salisbury, leading to the discovery of lime juice’s effectiveness against scurvy. This underscores the significance of fortification strategies in combating hidden hunger and improving the nutritional well-being of people.
The Indian government is aiming to fortify rice in all social safety net schemes by 2024, with the programme’s cost borne by it. This initiative has made impressive progress, significantly increasing the manufacturing capacity of Fortified Rice Kernel (FRK) to enhance the nutritional security of our population. The programme’s execution is being done in phases. It already covers Integrated Child Development Services (ICDS) and the Prime Minister’s Poshan Abhiyan in Phase-I, and will expand to include the targeted Public Distribution System (PDS) in 27 states and Union territories in Phase-II. Phase-III aims to achieve full coverage in all remaining districts by March 2024, except for those predominantly consuming wheat. The comprehensive implementation of fortified rice distribution will boost its availability and accessibility, promoting the nation’s health.
In 2016, this mission to combat malnutrition through food fortification gained momentum when the Food Safety and Standards Authority of India (FSSAI) established fortification standards for rice, wheat flour, edible oil, double fortified salt (DFS) and milk. The creation of a Food Fortification Resource Centre and introduction of the ‘+F’ logo helped food producers join the action. Further, the Centre mandated the use of fortified staples like DFS and fortified edible oil in safety net programmes.
The cost-effectiveness of the rice fortification process has been a driving factor in its adoption. The cost depends on various factors, including the rice industry’s structure, supply chain complexity, policies and programme scale. A low-cost extruder ranges from ₹35-40 lakh, while a high-quality one can cost up to ₹13.5 crore. Additional costs for fortified rice range from 1% to 10% of the retail price, with an approximate additional cost of ₹0.45 per kg to the consumer, depending on the nutrients added. As production and distribution expand, economies of scale could further reduce costs.
India’s young demographic profile, with youth comprising about a third of the population, is often seen as an advantage. However, the prevalence of micronutrient malnutrition poses a significant hindrance to human capital development, labour productivity and future social and economic progress. To address this, food fortification has emerged as a pivotal measure in improving the health of people and eradicating nutritional deficiencies. India’s national plans and initiatives like PM Poshan and the Anaemia-Mukt Bharat Mission underscore the importance of food fortification (and supplementation). The FSSAI actively advocates the fortification of staple foods, including oil, milk, wheat flour, rice and DFS. Among various fortification interventions, rice fortification stands out as an ideal strategy to bridge nutrient gaps. However, achieving equitable access to fortified foods requires sustained government investment. Notable challenges include raising awareness about the benefits of fortification, managing costs, ensuring widespread availability and fostering better coordination among stakeholders. With dedicated efforts, significant progress in the Indian population’s nutritional status can be achieved through this strategic approach.
Mukul Anand contributed to the article.