Micronutrient deficiencies pose a significant public health challenge in India, highlighted by alarming statistics. In an exclusive video interview with The Economic Times (ET), Microsoft co-founder and philanthropist Bill Gates highlighted the significance of food fortification and discussed India’s potential to transform its food distribution system into a more diverse dietary model to tackle this urgent challenge.
According to the National Family Health Survey (NFHS) 2019-21, anemia affected 68.4% of children and 66.4% of women in India. The National Center for Biotechnology Information identified the most prevalent micronutrient deficiencies as vitamin D deficiency (61%), iron (54%), vitamin B12 (53%), folic acid (37%), and iodine deficiency (17%). Additionally, the 2019 Comprehensive National Nutrition Survey found that 19% of preschool children and 32% of adolescents were zinc deficient, while 23% of preschool children and 37% of adolescents were deficient in folate. These deficiencies contribute to “hidden hunger,” where individuals lack essential nutrients despite consuming enough calories.
Food Fortification as a Strategic Solution
India has embraced food fortification as a critical strategy to combat malnutrition. Food fortification has emerged as a long-established and cost-effective strategy, adding essential vitamins and minerals to staple foods like rice, milk, and salt. This method improves the nutritional quality of commonly consumed foods without requiring significant changes in dietary habits. Strict guidelines govern the fortification process to prevent overdoses, making it a safe and culturally acceptable approach.
Bill Gates, in the ET interview, emphasized the importance of food fortification and innovation in tackling malnutrition, stating, “In the U.S., we’ve moved from traditional food distribution to systems like food stamps, which allow for dietary choice. India, too, can eventually shift from PDS as incomes rise and consumers become more educated.” Gates highlighted three key areas for improvement: “One, help pregnant women with the multiple micronutrient supplementation. We are working with Indian manufacturers to get the cost of that down.“
Gates stressed the need for holistic approaches, including quality control and effective monitoring systems. “We are learning from PDS and midday meal schemes about how to enhance nutritional impact,” he said.
Recent discussions at the Gates Foundation’s Goalkeepers Report 2024 launch, have emphasized the critical role of innovative technologies in enhancing food fortification. Similarly, the Biochemistry & Nutrition Division of ICAR-CIFT and the Food and Agriculture Organization‘s discourse on food fortification technologies underscored various approaches and the necessity for innovative strategies to effectively tackle micronutrient deficiencies.
Key technologies in Food Fortification
- Microencapsulation: Enhances the stability and absorption of vitamins and minerals while preserving their physical and chemical properties.
- Spray Drying: Produces stable microcapsules by dehydrating an emulsion of wall and core materials
- Freeze Drying: Removes moisture at low temperatures for superior product quality.
- Coacervation: Creates microcapsules with controlled release using bio-polymers.
- Extrusion: Combines materials to form denser microcapsules.
- In Situ Polymerization: Enhances stability by polymerizing materials around nutrients.
- Liposome Entrapment: Uses lipid bilayers to encapsulate nutrients, though at a higher cost.
- Fluidized Bed Drying: Coats solid core materials for better stability.
- Iodine Fortification: Implemented primarily through iodized salt and exploring alternative vehicles like milk and bread.
- Iron Fortification: Utilizes cereal products as vehicles with various fortificants while ensuring bioavailability.
- Vitamin A Fortification: Applied to margarine, milk, and cereals, though moisture poses stability challenges.
- Vitamin D and E Fortification: Limited to specific vehicles, with ongoing optimization research.
- Vitamin C and B-Complex Fortification: Existing technologies for fortifying juices and cereals, though stability remains a concern.
Read more: Biochar: Modernizing Indian Agriculture with Ancient Wisdom
India’s Strategy to Combat Micronutrient Deficiencies
India has launched several key programs to support pregnant women with micronutrient supplements. The National Health Mission (NHM) provides iron and folic acid supplements during antenatal visits, while the Integrated Child Development Services (ICDS) offers fortified food to improve nutrition for pregnant and lactating women. The Janani Suraksha Yojana (JSY) encourages institutional deliveries and provides cash incentives, ensuring access to essential health services, including micronutrient supplementation. These targeted initiatives aim to reduce maternal anemia and enhance health outcomes for mothers and their children across the country.
The Public Distribution System (PDS), established to tackle food scarcity, distributes essential foodgrains at affordable prices. Launched in the 1960s, it expanded to reach vulnerable populations through targeted initiatives like the Antodaya Anna Yojana (AAY). Gates acknowledged that while the inexpensive cereals distributed through the PDS currently help consumers, there is room for improvement in reducing anemia levels through targeted interventions.
The Mid-Day Meal (MDM) Scheme, launched in 1995, provides crucial nutritional support to children in government schools. Initially focused on primary students, it has expanded to include upper primary classes and now serves children in various educational institutions, including madrasas. The scheme aims to improve nutritional status, boost attendance among disadvantaged groups, and offer support during summer vacations in drought-affected areas. Gates praised its targeting and noted, “This is where we are strongly looking at interventions to reduce anemia through better food options.”
India faces the dual challenges of malnutrition and rising obesity, with Bill Gates highlighting the need to address both issues as super-processed diets become more common. The Indian Council of Medical Research (ICMR) is fostering innovation to combat these pressing concerns. Gates commended India’s strides toward self-sufficiency, which enhance resilience against global challenges. He views the youth as key to future economic growth and emphasizes the importance of nutritional diversity through collaboration among government, industry, and technology. Gates envisions a future where India’s food security supports both basic needs and a healthier, more varied diet for all.
