Double Fortified Salt: Opportunities and Challenges

December 11, 2020 / Comments Off on Double Fortified Salt: Opportunities and Challenges

 

India is home to one in every three of the world’s malnourished children. More often than not, these children fail to achieve their full cognitive and physical potentials, and in-turn grows up to become undernourished parents – giving rise to a vicious cycle of malnutrition.

Of all the forms of malnutrition, the major issue with today’s rapidly growing India is that of ‘Hidden Hunger’ – which is associated with micronutrient deficiencies in diets. These deficiencies are affecting all population groups in India – urban, rural, rich, poor, old, and young – but with women and children most at risk. For instance, a major public health issue currently in India is the high prevalence of iron-deficiency anaemia with 58% of children and 53% of the women found to be anaemic (NFHS-4).

With over 70% of the Indian population consuming less than half the daily recommended dietary allowance of micronutrients[1], government agencies, research institutions and development partners in India are increasingly looking at food fortification as a viable strategy to address malnutrition. According to a World Bank study, “probably no other technology available today offers as large an opportunity to improve lives and accelerate development at such low cost and in such a short time [as fortification does to address micronutrient deficiency]”.

Double Fortified Salt (DFS) is one such fortification strategy that can be used to combat Iron-Deficiency Anaemia. Salt was initially fortified with Iodine under the Universal Salt Iodization (USI) program to address Iodine Deficiency Disorders (IDDs). Since the implementation of the USI in India, salt iodization has achieved remarkable success and currently reaches roughly 92.4% of the population in the country (India Iodine Survey, 2018 – 2019). With no doubt, it is one of the most successful public health interventions and has been credited with the virtual elimination of iodine deficiency disorders in most countries of the world.

The Advantages of Salt Fortification:

  1. Salt is universally consumed by all: Salt is a condiment that is consumed by virtually all population groups in India – Rich/ Poor; Male/ Female; Urban/ Rural – and is therefore a perfect fortification vehicle.
  2. Salt Fortification is simple, effective, and an easy process.
  3. Easy monitoring of quality: Production of salt is limited to few centres, hence monitoring of quality is relatively easy.

The success of this Universal Salt Iodization program has encouraged innovators and public health practitioners to explore the potential of iodized salt to carry additional nutrients to solve critical vitamin and mineral deficiencies, in particular iron, to address anaemia caused by iron deficiency.

While the potential impact of DFS in combating anaemia is clear, it has its own challenges cut across policy, production issues, financial constraints and cultural habits.

The Challenges Involved with Double Fortified Salt (DFS):

  1. Technical Challenges: Adding iron to iodized salt may sometimes lead to adverse changes in the product, specifically discolouration. As a result of these sensory changes, the food product is sometimes considered ‘adulterated’ and might not be socially or culturally acceptable in the rural and vulnerable population.
  2. Production and Financial constraints: While 38% of the salt is produced by small and medium-scale producers, they constitute 94.2% of all salt producers[2]. The high capital costs of blending machinery often make it difficult for small scale producers to produce DFS as per required standards.
  3. Consumer Costs and Market Demand: As a result of higher input costs – both for input salt and the iron compound, DFS is more expensive to produce than iodized salt and thus has a higher ex-factory price. The beneficiaries have to be sensitized on the benefits of DFS to improve market demand in private markets and consumption in social safety net pockets. Scaling-up of DFS thus requires high investment and commitment in behavioural change and communication strategies.

While the above-mentioned points are definitive challenges in the sector today, it will be interesting to see how research institutions, development partners and government agencies overcome these hurdles in the years to come.

If the above challenges can be addressed, adding iron to iodized salt will be a promising option for improving iron intake in a country such as India where anaemia is a leading cause for maternal mortality and a major public health problem.

References:

  1. National Nutrition Monitoring Bureau. Hyderabad: National Institute of Nutrition; 2002.
  2. http://tnsalt.com/tnsalt-new/subcategory.php?sub_id=MTA3

 

Full Names of the Authors with Designations:

  • Dr Chandrakant S. Pandav, President, Indian Coalition for Control of

Iodine Deficiency Disorders (ICCIDD), New Delhi, India

  • Kartheek Reddy N, Executive Program Officer, Indian Coalition for Control of

Iodine Deficiency Disorders (ICCIDD), New Delhi, India

  • Vignesh Reddy GV, Executive Program Officer, Indian Coalition for Control of

Iodine Deficiency Disorders (ICCIDD), New Delhi, India

 

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