Over-Fortification

In October, India's Food Safety and Standards Authority of India (FSSAI), a Union Health Ministry body, took a decisive step towards tackling India's malnutrition crisis.

Draft Food Safety and Standards (Fortification of Foods) Regulations 2016

The made public a draft Food Safety and Standards (Fortification of Foods) Regulations 2016 that specifies that all fortified food, manufactured, packed, labelled, handled, distributed and sold, "whether for profit or under a Government-funded programme", ought to adhere to a minimum set of standards.

Salt-makers would have to ensure that no less than 30 parts per million (ppm) of iodine ought to be present when manufactured. Also, the iron content of salt ought to be 850-1100 ppm.

Similar standards are specified for vegetable oil and milk to be fortified with vitamin A or vitamin D.

Moreover, every package of food, fortified with iron needs to state that it is is "not recommended for people with thalassemia and people on low iron diet".

The target foods to be fortified also include rice, maida, vanaspati and atta, which would be enriched - in different combinations - by iron, iodine, zinc, vitamin A, vitamin D, folic acid (vitamin B9), thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6) and cobalamin (vitamin B12).

Need for standards

The World Bank's "Nutrition at a Glance" research report states that India loses over $12 billion in GDP to vitamin and mineral deficiencies; 48 per cent of children under the age of five are stunted, 43 per cent are underweight, 20 per cent are wasted, and more than 1 in 4 infants are born with a low birth-weight.

So far there is no requirement that certain foods undergo mandatory fortification. FSSAI's move comes in the wake of concerns of "over-fortification" of food.

Over-fortification

Fortified foods currently on the market are at risk of being consumed too much of three nutrients by young children - vitamin A, zinc and PM 05:27 30-12-2016

Fortified breakfast cereals are a key source of excessive intake because all three nutrients are added to fortified foods in amounts calculated for adults, not children.

Pregnant women and older adults may also be consuming too much vitamin A from other fortified foods, such as snack bars.

Vitamin A, zinc, and niacin are all necessary for health, but excessive doses can cause toxic symptoms.

Routinely ingesting too much vitamin A from liver-supplements can, over time, lead to liver damage, skeletal abnormalities, peeling skin, brittle nails and hair loss. In older adults, high vitamin A intake has been linked to hip fractures. Taking too much vitamin A during pregnancy can result in developmental abnormalities in the foetus.

High zinc intake can impair copper absorption and negatively affect red and white blood cells and immune function.

Niacin is less toxic than vitamin A and zinc, but consuming too much can cause short-term symptoms such as rash, nausea and vomiting.

Is the situation grave in India, yet?

Over-fortification wouldn't be a problem in India. The permissible range of nutrients that were allowed to be added are well below the body's maximum tolerable limits. The top manufacturers of processed food may be able to comply with the requirement but cottage industries or smaller manufacturers may be hard-pressed.