A report has flagged issues due to threats posed to anaemic persons over iron over-nutrition created by rice fortification.

Highlights of the report

• No prior education: The activists discovered that neither field functionaries nor beneficiaries had been educated about the potential harms.
• No warnings issued: There were no warning labels despite the food regulator’s rules on fortified foods.
• No informed choice: The right to informed choices about one’s food is a basic right. In the case of rice fortification, it is seen that no prior informed consent was ever sought from the recipients.

What are the risks highlighted?

• Thalassemia, sickle cell anaemia and malaria are conditions where there is already excess iron in the body, whereas TB patients are unable to absorb iron.
• Consumption of iron-fortified foods among patients of these diseases can reduce immunity and functionality of organs.

Endemic zones identified

• Jharkhand is an endemic zone of sickle cell disorder and thalassemia, with a prevalence of 8%-10%, which is twice the national average.
• Jharkhand is also an endemic zone for malaria — in 2020, the State ranked third in the country in malaria deaths.

What is Fortification?

• The Food Safety and Standards Authority of India (FSSAI) has explicitly defined fortification.
• It involves deliberate increasing of the content of essential micronutrients in a food so as to improve the nutritional quality of food and to provide public health benefit with minimal risk to health.

Types of food fortification

Food fortification can also be categorized according to the stage of addition:

1. Commercial and industrial fortification (wheat flour, cornmeal, cooking oils)
2. Biofortification (breeding crops to increase their nutritional value, which can include both conventional selective breeding, and genetic engineering)
3. Home fortification (example: vitamin D drops)

How is fortification done for rice?

• Various technologies are available to add micronutrients to regular rice, such as coating, dusting, and ‘extrusion’.
• The last mentioned involves the production of fortified rice kernels (FRKs) from a mixture using an ‘extruder’ machine.
• It is considered to be the best technology for India.
• The fortified rice kernels are blended with regular rice to produce fortified rice.

How does the extrusion technology to produce FRK work?

• Dry rice flour is mixed with a premix of micronutrients, and water is added to this mixture.
• The mixture is passed through a twin-screw extruder with heating zones, which produces kernels similar in shape and size to rice.
• These kernels are dried, cooled, and packaged for use. FRK has a shelf life of at least 12 months.
• As per guidelines issued by the Ministry of Consumer Affairs, Food and Public Distribution, the shape and size of the fortified rice kernel should “resemble the normal milled rice as closely as possible”.
• According to the guidelines, the length and breadth of the grain should be 5 mm and 2.2 mm respectively.

But why does rice have to be fortified in the first place?

• India has very high levels of malnutrition among women and children.
• According to the Food Ministry, every second woman in the country is anaemic and every third child is stunted.
• Fortification of food is considered to be one of the most suitable methods to combat malnutrition.
• Rice is one of India’s staple foods, consumed by about two-thirds of the population. Per capita rice consumption in India is 6.8 kg per month.
• Therefore, fortifying rice with micronutrients is an option to supplement the diet of the poor.

What are the standards for fortification?

• Under the Ministry’s guidelines, 10 g of FRK must be blended with 1 kg of regular rice.
• According to FSSAI norms, 1 kg of fortified rice will contain the following: iron (28 mg-42.5 mg), folic acid (75-125 microgram), and vitamin B-12 (0.75-1.25 microgram).
• Rice may also be fortified with zinc (10 mg-15 mg), vitamin A (500-750 microgram RE), vitamin B-1 (1 mg-1.5 mg), vitamin B-2 (1.25 mg-1.75 mg), vitamin B-3 (12.5 mg-20 mg) and vitamin B-6 (1.5 mg-2.5 mg) per kg.

How can a beneficiary distinguish between fortified rice and regular rice?

• Fortified rice will be packed in jute bags with the logo (‘+F’) and the line “Fortified with Iron, Folic Acid, and Vitamin B12”.

Advantages offered

• Health: Fortified staple foods will contain natural or near-natural levels of micro-nutrients, which may not necessarily be the case with supplements.
• Taste: It provides nutrition without any change in the characteristics of food or the course of our meals.
• Nutrition: If consumed on a regular and frequent basis, fortified foods will maintain body stores of nutrients more efficiently and more effectively than will intermittently supplement.
• Economy: The overall costs of fortification are extremely low; the price increase is approximately 1 to 2 percent of the total food value.
• Society: It upholds everyone’s right to have access to safe and nutritious food, consistent with the right to adequate food and the fundamental right of everyone to be free from hunger

Issues with fortified food

• Against nature: Fortification and enrichment upset nature’s packaging. Our body does not absorb individual nutrients added to processed foods as efficiently compared to nutrients naturally occurring.
• Bioavailability: Supplements added to foods are less bioavailable. Bioavailability refers to the proportion of a nutrient your body is able to absorb and use.
• Immunity issues: They lack immune-boosting substances.
• Over-nutrition: Fortified foods and supplements can pose specific risks for people who are taking prescription medications, including decreased absorption of other micro-nutrients, treatment failure, and increased mortality risk.

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