Why is Rice Fortification Necessary and Beneficial to India?
Because India has a high percentage of anemia, which is one of the impediments to the growth of children and the nation.
“Malnutrition and lack of essential nutrients in poor women and poor children pose major obstacles in their development. In view of this, it has been decided that the government will fortify the rice given to the poor under its various schemes. Be it the rice available at ration shops or the rice provided to children in their mid-day meals, the rice available through every scheme will be fortified by the year 2024,” Priminister Narendra Modi announced on August 15th, 2021, in his speech from Redfort.
I know that he must have been thinking of alleviating Malnutrition in India for a long time. In our meeting in 2010 at his residence, he asked me what India should do to become a developed country. “Reducing Malnutrition to the lowest level possible,” I said.
I was surprised by his keen interest and deep questioning on this subject at the meeting with no specific agenda. His questions and my responses went on for the next 30 minutes. Since then, I am sure he must have met and discussed reducing malnutrition with many scientists and policymakers. Among the several reactions to the announced Rice Fortification Program, the personal opinions of Dr. Anura Kurpad and Harshapal S. Sachdev need a response to dispel the ‘negative ‘ aspect of the article that are not supported by research data.
In their article, they have mentioned six myths. I have presented my response to each one of them below.
1. Is universal rice fortification required? YES!
By changing the how-to measure and the healthy range, data can be manipulated as per the author’s needs. BUT, the latest National Family Health Survey 2019–20, in 15 of 22 states and UTs, data shows more than half the children are anemic. Similarly, more than 50 percent of women are anemic in 14 of these states and UTs. The authors also agreed that there is a daily iron deficit. Therefore there is a need for a large-scale nationwide rice fortification program for India.
2. Is the high anemia prevalence inflated? NO.
Measurement method details and WHO cut-off part, India has a high level of anemia. Anemia is linked to deficient in Iron. Two independent research publications ( Simon I. Hay 2021 & Cate Dewey 2018 ) demonstrate this. The latest report of the National Family Health Survey 4 2019–2020 also shows it. If this is wrong, I request Dr. Anura Kurpad and Harshapal S. Sachdev to show that this survey is wrong before stating that Rice fortification is unnecessary and potentially risky.
3. Fortification requires no behavioral modifications. YES!
It is not true that every variety of rice needs its type of Fortified rice kernel. In our experience, the rice kernel from Tamilnadu or Rajatham local varieties are used with Andhra and Tenegana people without any complaints or issues. Creating a fear that Fortified rice kernels will reduce the diversity of rice varieties is baseless and biased against the Rice fortification program.
4. Diet diversity will never occur in India. It will take time
Yes, it’s true that if one can consume 250–300 grams of diverse cereals with green leafy vegetables, it can need nutrients, not only Iron. Let’s see the details. The typical cooked rice content of Iron varies from 0.2- 0.8 milligrams per 100 grams. To get half of the NIN suggested daily Iron of 18mg for men and 29mg for women, one has to eat kilos of rice, which is neither practical nor advisable. It is possible with some millets, but their consumption is reduced from 1962 to 201and need a lot of work to improve its consumption. While 106 million tons of rice is consumed, millets account for only 11.4 Million tons which is only 10% of Rice production.
5. Rice fortification will successfully prevent anemia
The Cochrane report is complex, and there are many points in it. The authors have taken only one and dropped the other — Fortification of rice with Iron alone or in combination with other micronutrients may make little or no difference in the risk of having anemia but probably reduces the risk of iron deficiency and increases mean hemoglobin concentrations in the population aged two years.
Further, the report did not consider the data from India that showed the reduction in anemia and improved the cognitive skills of children.
6. Iron fortification is safe and is the need of the hour
Rice fortified with Iron, as suggested by FSSAI, will be safe as the level of absorption is low from vegetable rice ( 3%) compared to nonvegetarian sources ( 50%). In addition, the daily Upper Level of Intake can be as high as 45, yet safe for humans, as per the Australian guidelines.
In reality, there is a need for a rice fortification program. It has been implemented in different locations in India. Akashyapatra does some 450,000 midday meals with Fortified rice daily. Fortified rice per midday meal costs an additional 10 paise per meal.
As the authors suggested, government and researchers must encourage simple natural solutions for Anemia Mukt Bharat. Until then, the Rs.2,600 crores per years expenditure for fortified rice kernels for public rice distribution is undisputably a useful, cost-effective expenditure with no risks.
The truth is India did not invest enough research time, money, and effort to establish its own clinical and biological reference standards and to develop biofortified varieties of crops. It just started now spending on both food fortification and biofortification of crops to alleviate malnutrition. In addition, India needs complete references standards/ Reference Intervals for its population. The progress on these fronts is imperative for India to be a healthy, wealthy, and developed country.
