Experts raise concerns over mandatory fortification of food items

Letter to FSSAI warns of adverse impact of policy on health and livelihoods.

Published - August 02, 2021 08:11 pm IST - NEW DELHI:

In a pushback against the Centre’s plan to mandatorily fortify rice and edible oils with vitamins and minerals, a group of scientists and activists have written to the Food Safety and Standards Authority of India (FSSAI), warning of the adverse impacts on health and livelihoods. They cited multiple studies to show that dietary diversity and higher protein consumption are key to solving undernutrition in India, rather than adding a few synthetic micronutrients which could harm the health of consumers.

The letter, sent on Monday to the FSSAI as well as the Food, Agriculture and Health Ministries and the Ministry of Women and Child Development, was signed by 170 individuals and organisations including eminent nutritionists, economists, doctors and farmers groups.

‘Inconclusive evidence’

One of the signatories is the National Institute of Nutrition’s former deputy director Veena Shatrugna, who warned that “evidence supporting fortification is inconclusive and certainly not adequate before major national policies are rolled out.”

The letter points to recent studies published in the medical journal Lancet and in the American Journal of Clinical Nutrition which show that both anaemia and Vitamin A deficiencies are overdiagnosed, meaning that mandatory fortification could lead to hypervitaminosis.

It also notes that many of the studies which FSSAI relies on to promote fortification are sponsored by food companies who would benefit from it, leading to conflicts of interest. Studies funded by the Nestle Nutrition Institute and the Global Alliance for Improved Nutrition were mentioned as cases in point.

The letter explains that one major problem with chemical fortification of foods is that nutrients don’t work in isolation but need each other for optimal absorption. Undernourishment in India is caused by monotonous cereal-based diets with low consumption of vegetables and animal protein.

“Adding one or two synthetic chemical vitamins and minerals will not solve the larger problem, and in undernourished populations can lead to toxicity,” it said, citing a 2010 study that showed iron fortification causing gut inflammation and pathogenic gut microbiota profile in undernourished children.

Cartelisation

The letter also argued that mandatory fortification would harm the vast informal economy of Indian farmers and food processors including local oil and rice mills, and instead benefit a small group of multinational corporations who will have sway over a ₹3,000 crore market.

“Just five corporations have derived most of the benefits of global fortification trends and these companies have historically engaged in cartelising behaviour leading to price hikes,” said the letter, noting that the European Union has been forced to fine these companies for such behaviour and asked how the FSSAI proposed to regulate price in India.

Dietary diversity was a healthier and more cost-effective way to fight malnutrition, said the letter. “Once iron-fortified rice is sold as the remedy to anaemia, the value and the choice of naturally iron-rich foods like millets, varieties of green leafy vegetables, flesh foods, liver, to name a few, will have been suppressed by a policy silence,” it warned.

“It is ridiculous that the government is promoting polished rice, which has lost a lot of its nutrition on the one hand, and talks about chemical fortification on the other hand,” added another signatory, Debal Deb of the Basudha Laboratory for Conservation in West Bengal.

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