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Bid to check malnutrition through fortified flour

posted Nov 24, 2011, 9:40 AM by Puneet Goyal
The Madhya Pradesh Government is all set to distribute fortified flour from November 22 in a bid to counter malnutrition, reports Girish Sharma

There has been a lot of controversy regarding the benefits of enriched flour in relation to those of whole wheat flour. Although enriched flour does contain the similar amounts of vitamins as the unrefined flour products, it does not have the same nutritional benefits of whole wheat flour.

To counter the widespread malnutrition in Madhya Pradesh, the State Government is all set to distribute fortified flour in Madhya Pradesh from November 22. The similar project launched in Rajasthan last year was strongly opposed by the local people stating that despite being nutrients in the flour, the quality is poor.

The Global Alliance for Improved Nutrition (GAIN), which had advocated the campaign in this regard in Rajasthan and Gujarat, would launch a similar drive in Madhya Pradesh too.The massive food fortification drive claims to bring down high levels of anaemia and Vitamin A deficiency that has been hampering the State's progress and economic growth for several years.

The World Food Programme (WFP) had earlier conducted a similar project on empirical basis in three districts of Madhya Pradesh- Shivpuri, Guna and Sheopur. For the purpose, the WFP is funding local voluntary organisations for fortification of flour and distributing it among the villagers.

Later, the project was withdrawn because the programme could not fulfill the objectives of collecting evidences and data.However, it has been a debatable issue whether a written consent should be needed from consumers, who are consuming it.

If one goes by the latest human development report of Madhya Pradesh, the state of health in Madhya Pradesh is far from satisfactory. This is reflected from the latest estimate for longevity, measured as life expectancy at birth, which was 59 years for males and 58 years for females.As per the latest estimate on longevity as quoted in the Human Development Report 2007, the life expectancy for males and females in Madhya Pradesh was the lowest among all the major States in India and a good four to eight years lower than the national average.

State Advisor to Supreme Court Commissioner in Right to Food case Sachin Jain said significantly, there is not a clear situation regarding fortification of flour with iron and folic acid. As per rules, the quantity of iron should be monitored, but it is not being monitored properly at several places and thus negative effects have been witnessed at several places.In malaria-prone areas, iron fortification needs to be monitored properly because the patients may face problems with the iron fortified flour consumption, he added.

Jain informed that the concept of fortification has been a success only in the States where there is strong network of primary health centres, but in Madhya Pradesh this network is quite poor. "If anybody faces health disorders, he needs to immediately approach primary health centres, thus in the areas where PHCs are available, this has been a success," he informed. The flour fortification project that was launched in Gujarat has been challenged in Supreme Court, he said.

He further said that after fortification, the flour has medicinal components, but globally, natural food is considered as the best food. Thus, the Government should make efforts in making available natural foods to the people, he advised. Jain stated that the interests of MNCs are involved in the project, which need to be checked and the whole process should be in public interest.

General secretary of the Roller Flour Mills Federation of India (RMFI) Veena Sharma told that there has been no incident of ill effects of the fortified flour. She informed that it requires at least four to five months for positive results of the fortification, thus similar time would be required for the ill effects. Thus, the misconceptions if any are plainly on here say, she claimed. Regarding case pending in the Supreme Court against Gujarat Government, Sharma stated that it was regarding no reducing the quantity of grain provided through the PDS in Gujarat.

Difference in amount of fibre

One of the most significant differences is the amount of fibre. During the production of white enriched flour, a lot of the fibre-containing components (the bran and germ) are reduced or removed. Thus, products made from this type of flour contain smaller amounts of fibre than those made with whole wheat flour.

Another concern is the effect on blood sugar levels. Enriched flour products tend to be higher on the Glycemic Index, quickly raising blood sugar levels. In contrast, foods made from whole grains tend to be lower on the Glycemic Index. Because they contain higher amounts of fibre and other complex carbohydrates, they take longer to digest; therefore, sugars enter the bloodstream in a slow and more controlled manner.

However, experts feel that there are more benefits with the fortification of the flour and thus there is no worry to use it.

Vitamin and Mineral Deficiencies

Milk, milk products, fruits, vegetables, egg, fish, and meat are the best sources of micronutrients, ie vitamins and minerals. But in Madhya Pradesh, per-capita consumption of these micronutrient-rich foods across all socio-economic and demographic groups is very low. Hence MP has high levels of micronutrient malnutrition; especially anemia and vitamin A deficiency. According to theNFHS-3, prevalence of anemia is very high amongst all population and socio-economic groups. In MP, 74 per cent of children 6-59 months, 58 per cent women and 25 per cent men are anaemic. Anaemia and vitamin A deficiency are major contributors to the low-vitality and mortality, especially of women and of children under five.