Food-based Approach to Combat Micronutrient Deficiencies

Abstract

Cereal-pulse-based diets of developing countries like India are qualitatively deficient in micronutrients (vitamins and minerals) – “the hidden hunger”. Micronutrient deficiencies adversely impact health and consequently, medical expenditure and productivity. Approaches for combating dietary micronutrient deficiencies include: pharmaceutical supplementation; food fortification (salt, wheat flour, milk, oil) or addition of micronutrient powder to cooked food; and dietary diversification through nutritionally sensitive agriculture. Bio-fortification utilising conventional breeding and genetic engineering can help to develop micronutrient-rich varieties of plant foods.

In India, supplementation programmes like, iron-folic acid supplementation to combat anaemia due to iron deficiency and massive dose vitamin A programme to combat vitamin A deficiency have had limited impact, perhaps due to administrative infirmities and lack of awareness and compliance. Food fortification is a promising medium-term approach. It needs careful planning, in terms of items to be fortified, type and quantum of nutrients to be added, food habits, monitoring etc. Iodine fortified salt has helped reduce the incidence of iodine-deficiency disorders. Salt fortified with combination of iodine and iron (double fortified salt-DFS) has been developed and needs to be scaled up. Efficacy of fortified staple foods and fortification of cooked food with multiple micronutrient powder have been established but require implementation at
national level. Dietary diversification by leveraging agriculture for nutrition security (LANS) is a long-term, sustainable strategy. It has positive impact if accompanied by behavioural change communication (BCC) and women’s participation. Studies in India and countries of South Asia and Africa have shown that, homestead production of micronutrient-dense vegetables and fruits particularly green leafy vegetables can increase the intake of micronutrients. Backyard poultry with high egg-yielding breeds and fewer birds has shown positive impact on household egg consumption. However, LANS cannot be a stand- alone strategy when farm holdings are very small. It requires integration of a package of interventions and proper monitoring.