Deficiencies in three micronutrients — iodine, iron, and vitamin A — are widespread affecting more than a third of the world's population. Individuals and families suffer serious consequences including learning disabilities, impaired work capacity, illness, and death. They could waste as much as 5% of gross domestic product (GDP). India's life expectancy has more than doubled, and infant mortality, halved in the last fifty years. India is knocking the door for a permanent position in the United Nations and is one of the few atomic power countries in the world. However, paradoxically, we have the highest number of malnourished people in India and our child malnutrition rate is unacceptably high. With one sixth of the global population residing in India, one third of about two billion people suffering from vitamin and micronutrient deficit are in India. The intake of micronutrients in daily diet is far from satisfactory and largely less than 50% RDA is consumed by over 70% of Indian population. The loss due to micronutrient deficiency costs India 1 percent of its GDP. This amounts to a loss of Rs. 27,720 crore per annum in terms of productivity, illness, increased health care costs and death.
Every day, more than 6,000 children below the age of five die in India. More than half of these deaths are caused by malnutrition-mainly the lack of Vitamin A, iron, iodine, zinc and folic acid. About 57% of preschoolers and their mothers have subclinical Vitamin A deficiency. Anemia prevalence among children under five years is 69% and among women it is over 55% in a recently concluded national study. With the scientific reality of anemia being a late result of iron deficiency, these data reflect an almost universal iron deficiency in Indian population.
The consequences of micronutrient malnutrition are unacceptably high morbidity and mortality. Vitamin A, iron and zinc deficiency when combined constitute the second largest risk factor in the global burden of diseases; 330,000 child deaths are precipitated every year in India due to vitamin A deficiency; 22,000 people, mainly pregnant women, die every year in India from severe anemia; 6.6 million children are born mentally impaired every year in India due to iodine deficiency; intellectual capacity is reduced by 15 per cent across India due to iodine deficiency; and 200,000 babies are born every year with neural tube defects in India due to folic acid deficiency.
The basic objective of all national micronutrient programs is to ensure that needed micronutrients are available and consumed in adequate amounts by vulnerable populations. Strategies should be appropriate to the need and should use existing delivery systems and available technologies where they serve that need. A combination of interventions involving the promotion of breastfeeding, dietary modification (e.g., improving food availability and increasing food consumption), food fortification, and supplementation may need to be emphasized and implemented. The fortification of commonly eaten foods with micronutrients is one of the main strategies that can be used to improve micronutrient status. Fortification should be viewed as part of a range of measures that influence the quality of food including improved agricultural practices, improved food processing and storage, and improved consumer education to adopt good food preparation practices. Today, in developed countries where there is a high dependence on processed foods and industries are streamlined and automated, food fortification has played a major role in the health of these populations over the last 40 years, and several nutritional deficiencies have been eliminated. In the developing countries too, fortification is increasingly recognized as a measure to improve the micronutrient status of large populations. When fortification is imposed on existing food patterns, it may not necessitate changes in the customary diet of the population and will...