As the Centre looks to expand its programme on the fortification of rice distributed through the Public Distribution System (PDS) to address chronic anemia and micro-nutrient deficiency, around 18 experts in a recent paper have argued that programme ignores the central role of balanced and diverse diet in addressing a variety of nutritional problems of India.
Advocating extreme caution while going ahead with the programme, the authors said that the new nutrient recommendations of the Indian Council of Medical Research and National Institute of Nutrition (NIN) show that a diverse natural diet is adequate to meet the normal micronutrient need of the population.
“Therefore, fortification of rice with iron without diversifying the diet will make very little difference, if at all,” the paper said.
The paper titled, ‘When the cure might become the malady: The layering of multiple interventions with mandatory micronutrient fortification of foods in India”, was published in the American Journal of Clinical Nutrition on July 28, 2021.
The Centre in a recent reply in Parliament had said that it is running a pilot scheme on fortification of rice and its distribution through the PDS for a period of 3 years starting from 2019-20 with a total outlay of Rs 174.64 crore.
The pilot focuses on 15 districts across 15 states, preferably 1 district per and so far six states namely Andhra Pradesh, Gujarat, Maharashtra, Tamil Nadu, Chhattisgarh and Uttar Pradesh have started distribution of fortified rice under the Pilot Scheme in their selected districts.
The Centre in the reply also said that FCI which is responsible for procurement and supply of fortified rice for ICDS and mid-day meal programmes has so procured 0.66 million tonnes of fortified rice.
Meanwhile, Professor H P S Sachdev, one of the key authors of the paper in a statement said that fortification expenditure of only the rice delivered through the social safety networks will cost the public exchequer about Rs 2600 Crores annually, which in the backdrop of the already ongoing public health initiatives of iron supplementation, this represents an avoidable and wasteful expenditure with no palpable benefits, but on the contrary the risk of potential harm.
On the prevalence of chronic anemia, which has been elaborated as one of the main reason for the fortification programme, Dr Anura Kurpad, the lead author of the paper said that it is magnified because of the use of inappropriate haemoglobin cut-offs to diagnose the malady in children and pregnant women.
"It creates an ongoing perception of a stagnant or worsening anemia prevalence, however, it does not reflect the true nutritional status of a population," Kurpad said in the statement.