Iron Fortification

Subject – Governance

Context – Inescapable risks of mandatory iron fortification – Fortification will increase serum ferritin without changing haemoglobin level

Concept –

Iron is not safe in excess; it is an oxidant with a variety of ill-effects.
Iron increases the risk for many non-communicable diseases like diabetes, hypertension and even high blood cholesterol.
The iron body stores is measured by serum ferritin concentration.
Fortification of any one staple (rice, wheat, or salt) will increase serum ferritin, without necessarily changing the haemoglobin level.
No less than 50% of Indian children, aged 5-19 years, already had a biomarker of either high blood sugar or high blood lipids, even when thin or stunted.
The WHO is having a consultation this year to evaluate if haemoglobin diagnostic cut-offs for anaemia should be lowered in different geographies, one of which is India.
- This is partly based on a recent paper in The Lancet by us, that showed that the cut-offs were likely lower than the WHO cut-off in Indian children.
- This lowering has been also confirmed in a study of no less than 32 countries worldwide, as well as another in pregnant women.
- A lower cut-off will mean lower (halved) anaemia prevalence.

To know more about Fortified Rice, please refer August 2021 DPN.