Food fortification ecosystem
The writer is the Chancellor of Malir University of Science & Technology. He is also a former principal of Dow Medical College and Founding Chairman of Sindh Healthcare Commission. He can be reached at syedtsultan@gmail.com
Proper nutrition in the first 1,000 days of a child life is crucial to improved physical and cognitive development. Lack of adequate nutrition can affect a child adversely later in life, leading to poor cognitive skills, reduced schooling and more chances of ending up in poverty.
Despite the undeniable importance of having a balanced food intake in growing years, 1 in 4 of the world’s children suffer from stunted growth. In Pakistan, in 2021, 36.94% of the total population between the age of 0-14 is largely affected by malnutrition, whereas four out of ten children under five years of age are stunted while 17.7% suffer from wasting.
According to the findings of National Nutrition Survey 2018, the double burden of malnutrition is becoming increasingly apparent with almost one in three children underweight (28.9%) alongside a high prevalence of overweight (9.5%) in the same age group. Lack of adequate health care, access to a balanced diet during pregnancy, especially in the rural areas of the country is what sets the initial stage for malnourished children.
Pakistan, with a Global Acute Malnutrition (GAM) rate of 17.7%, is exceeding the emergency threshold, making it one of the biggest threats to our national productivity. Food insecurity, inadequate social and care environment, unhealthy environment, political instability, overpopulation are only some of the factors making the situation worse.
A health economics study by Aga Khan University estimates that the loss in income due to micronutrient deficiencies is about $3 billion annually or 1.33% of GDP, hence proving the theory that undernutrition is both a cause and a consequence of poverty. Poverty and undernutrition are locked in a vicious cycle of child morbidity and mortality, retarded physical and cognitive growth, diminished learning capacity and school performance, that ultimately lower adult productivity and earnings.
As the National Nutrition Survey 2018 indicates, iron is among the top most deficient nutrient in children under 5, among other deficiencies, leading to consequences such as impaired growth, frequent illness, fatigue, shortness of breath and a reduced ability to learn.
In an era, where world together is fighting against food insecurity and scarcity of resources, it is perhaps time for food scientists to look for more alternatives and nutritional solutions to meet an individual’s nutrition requirements in a more sustainable and reachable way. Beginning in 1920s, food fortification is now a widely used methodology to make up for the lack of micronutrients in the population’s diet, especially children.
In Pakistan, inadequate micronutrient intakes are prevalent in most Pakistani schoolchildren where more than 80% of children are below Calcium, Iron, Zinc and Vitamin A recommended intakes, 60% for Vitamin C, 25% for B Vitamins, and 75% for Folate. Regarding macronutrients, 64% of children have inadequate protein intake lower than the Acceptable Macronutrient Distribution Range (AMDR), 30% above the AMDR for total fat, while 10% are above the AMDR for carbohydrate. It has become imperative to promote nutritional solutions such as food fortification to ensure nutritional adequacy and facilitate these children to become an important and useful tool of society later in their lives.
With an increased focus on health and wellbeing and its direct impact on a country’s economic growth, governments and global health authorities are also now advocating and recognising the potential of food fortification as both an economical and a powerful way to fight malnutrition at a larger scale. It has become inevitable for the industry practitioners, moving forward, to achieve effective and responsible fortification practices and policies and address the most prevailing nutrient deficiencies such as Iron, on swift grounds and pledge our commitment to SGDs 2030, 2 — Zero Hunger by 2025.
This would require not only responsible innovative initiatives by food industry leading players but also the establishment of clear fortification guidelines by authorities keeping in account changing population demographics, changes in the food supply, and advances in technology.
Published in The Express Tribune, May 24th, 2023.
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