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Rethinking food fortification 🌾
On tackling stark disparities in nutrition through fortification + thoughts on other solutions
This week’s newsletter is a change of pace from the previous two essays. It’s also LONG so I appreciate you taking the time to read my somewhat jumbled-yet-organised thoughts. Next week is a fun piece on picnics and romance 🌸
The Reporters’ Collective came out with their big story on how the Indian prime minister Modi has announced that more than “half of Indians would be fed rice fortified with micronutrients by 2024 to eradicate anaemia”, a public health policy that tends to usually draw applause.
This policy aims feed more than 80 crore (800 million) Indians under different welfare schemes. Which means that these are the people who are marginalised, poor, and depend on food security schemes. The reason cited for this compulsory project is to tackle anaemia and micronutrient deficiencies with the help of rice fortified with iron, folic acid, and Vitamin B12. Granted, this policy was announced two years ago, when we were in the throes of covid, but the government seeks to complete it by next year. To that end, via the Food Safety and Standards Authority of India (FSSAI), the government has begun supplying some states with fortified wheat, milk, and oil.
So let’s unpack this. How do you fortify rice? Usually, rice grains are made into flour and shaped into a dough. Micronutrients are then added to this dough, which is chopped back into rice-like grains. The WHO recommends “large scale food fortification as a powerful evidence-informed and cost-effective intervention to fight vitamin and mineral deficiencies”.
Just how beneficial is fortified rice? Of course, this depends on what nutrients are being added, like iodised salt that has been widely implemented, with millions of Indians consuming it since the 60s; India was one of the first countries to initiate salt iodisation. Salt, however important an ingredient, is still consumed in limited quantities, and isn’t a staple food when compared to rice, milk, oil, and wheat.
There are two sides to this coin.
In India where malnutrition is omnipresent—and the country scores seriously low on the Global Hunger Index—food fortification seems like an imperative step towards tackling it. Many cite that food fortification is cost effective, globally recognised, and beneficial in tackling nutrient deficiencies in developing countries, especially if deficiencies are widespread (provided the processing is centralised); that it contributes to the country’s overall development; and is equally comparable to other public health programmes.
Of course where there are benefits, there are drawbacks as well. For one, the Union government announced the fortification plan without waiting for the results of test projects conducted to determine the efficacy of fortified rice. Second, the Alliance for Sustainable & Holistic Agriculture (ASHA)—comprising farmers’ organisations, consumer groups, women’s organisations, individual citizens, experts etc—has alleged that the Union government stands to financially benefit from the programme.
With fortified foods, there also remains the risk of nutrient overdose (as well as the opposite, an insufficiency of consumption). As the original report notes, “fortified rice is also harmful to people suffering from diseases that worsen with iron intake.” Fortified foods are also heavily processed, and more often than not, nutritionists, doctors, and experts always call for adding nutrients to the diet from as natural sources as possible. Not everyone who is meant to consume fortified foods under the project has access to a nutritionist or a doctor to chart them a new diet plan.
Bigger drawbacks still, lie with the sustenance of fortification. What is actually needed, is a long term solution, and one that aims at diversifying people’s diets so that their nutrition can be met through naturally grown and produced food, and not specially fortified foods that has potential risks. Midday meal schemes aimed at children in schools and rural day care centres are getting increasingly ‘vegetarian’, losing eggs, meat, and poultry from the meal plans. While consuming meat is constantly vilified in the media.
For a piece in The Wire, Dr Sylvia Karpagam, a public health doctor and researcher, writes, along with Dr. Siddharth Joshi, that “eggs are one of the most nutritionally dense foods containing good quality, bioavailable and digestible protein as well as nutrients such as folate, zinc, Vitamins A, B12 etc…” Dr Karpagam has long been challenging casteist ideas about diet and looking at nutrition policy through the caste lens, but the Union government seeks to impose its “Brahminical ideas of sattvic diet on school-going children”. So why add nutrients to a staple food like rice, when eggs are locally available, easier to transport and store, and offer the very same nutrients?
Earlier this year, there was also a 63% cut in the food grain subsidy for the poor, while in December 2022, the Union government “put an end to the free-food scheme that was rolled out during COVID-19”, based on the advice of think tank NITI Aayog, a report notes. So even as there is a rollout of fortified foods aimed at the poor, there has been a parallel movement in reducing food subsidies and security programmes. In a recent interview, Indian economist Jean Dreze spoke about “a massive cut in food subsidy this year” and bonus rations of 5kg/per person (which was beneficial during the covid-19 crisis) being discontinued.
The long term solution then, towards nutrition and food security hinges on the government making a diverse diet—one that includes meat and eggs—accessible to all, instead of placing substantial barriers on producers and consumers. The insistence of including meat, eggs, fish, and poultry in a diet isn’t the opposition of veganism; instead it is taking into account the conditions and the culture of a country’s eating habits that are regularly dictated by religion and caste. India’s structural inequality doesn’t just manifest into poverty but also in who gets to eat what.
Maybe there’s another solution, that’s not as noteworthy but crucial in many ways; a solution that looks to the past to help learn lessons of the future. Until the 70s, India had close to 1,10,000 varieties of rice, according to rice conservationist Debal Deb. But that diversity is now lost to the green revolution that prioritised monoculture and hybrid crops. For whom has the emergence of agriculture considered progressive?
“Now, only 6,000 species or varieties of rice survive… After the green revolution, a generation of farmers in India were injected with the belief that traditional farming methods were unscientific or anti-progress and they came to believe in the efficacy of high-cost and high-end scientific research. But the traditional varieties of rice were rich in iron and protein content, vitamin B, and had medicinal value,” said Dr. Deb in an interview in 2012.
Today, some community seed banks and non-governmental organisations are trying to preserve the country’s rich diversity of heritage and heirloom rice varieties that stands to be the best insurance against diseases and outbreaks, and not just for posterity. Heritage rice is also beneficial to those lacking the same micronutrients that the Union government looks to supplant with fortified foods. Arubathaam kuruvai rice, that resemble a mix of unpolished rubies and pearls, is known to be good for the heart, improves digestion, and can be consumed (in regulated quantities) by those suffering from diabetes. Mapillai Samba rice too is low in glycemic index, while Poongar (made into kanji) can help build immunity.
The more we depend on a single variety of crop to feed a growing population—even as prices rice, groundwater depletes, and change in weather patterns affect paddy—creating economies of scale and stacking as we go in commercial agriculture, the more risk we run in everything crashing down.
Look at the banana that is ubiquitous today—the Cavendish, which accounts for around 47% of global production. It is a “genetic outlier” notes Wired, because it is sterile and can reproduce by “creating clones of itself”. Cavendish bananas are popular because they’re known to be reliable and the plant produces lots of fruits, thus accounting for 99% of exports to developed countries. Cavendish bananas are a monoculture because of their genetic uniformity, which makes them susceptible to a host of diseases, fungal outbreaks, and eventual extinction.
Rice may have a similar story, one that might spell doom—fortified or not.
In Digestion is back, where James Hansen presents a “weekly survey of the best food media on the web”. His words, not mine. Mine are, excellent, read, subscribe... In the same corner of the internet, MB debuts The Goodies. Just thots and vibes on “highly urban food experiences”. The vibes are great—subscribe!
Also a shoutout to What’s That You’re Cooking Thea, by Thea Everett whose newsletter includes recipes, interviews, dinner ideas. Along with Rebecca May Johnson’s Dinner Document, it’s my comfort read. Subscribe!
I also wanted to include millets in this piece, seeing as it’s the ‘International Year of the Millets’ and how its reincarnation is celebrated in the country. Sudha Nagavarapu, a researcher-activist writes an important essay on how the millet revival is not what it seems.
Is Elaine Benes canonically hot? Yes, if you ask me (she’s fabulous), but because she’s played against type, it makes for a much funnier show.