A study among school children conducted by National Institute of Nutrition and Department of Biotechnology revealed a significant increase in mean serum ferritin (iron stores) levels (8.17 Hg/dL) after consumption of fortified rice . A significant reduction in the incidence of morbidity among children was observed in the experimental group. St. John’s National academy of Health Sciences, Bengaluru also reported an increase in the haemoglobin concentrations of children consuming iron-fortified rice whereas there was no increase in the control group . Community level projects in Andhra Pradesh, Rajasthan and Odisha have shown successful results.
Consumption of fortified wheat flour especially with iron and B vitamins is found to be an ideal and cost-effective medium to supplement the diets of general population with essential nutrients. Wheat flour fortified with iron (NaFeEDTA) was found to be efficacious in reducing iron deficiency anaemia (IDA) and iron deficiency (ID) prevalence among school aged children in Bengaluru and Pune. Gujarat’s model provided evidence that multi-micronutrient deficiencies can be dealt with the provision of fortified wheat flour through the government’s social safety-net schemes.
A landmark study in the Kangra Valley region, Himachal Pradesh was conducted from 1956 to 1972 (Sooch and Ramalingaswami, 1965). The study region was divided into A, B and C zones. After a baseline survey in 1956, the salt distributed to zones A and C was fortified with potassium iodide and potassium iodate, respectively, while zone B was supplied with unfortified salt. The salt fortification was at a level that supplied approximately 200 microgram of iodine per person per day. After six years of iodization, in 1962, a marked decrease in the prevalence of goiter was observed in zone A (from 38% to 19%) and zone C (38% to 15%) without any significant change in zone B. Six years later, in 1968, a systematic survey of goiter prevalence showed a further reduction in zones A and C (8.5% and 9.1% respectively). Thereafter, iodized salt was provided to Zone B also which was consuming non-iodised salt. Subsequent checks demonstrated a decline in goitre prevalence in this population as well, which was directly attributable to the introduction of iodized salt in the diet.
The efficacy of DFS in reducing anaemia and iron deficiency is proven. DFS providing 3.3 mg ferrous fumarate per kg of iodized salt led to significant improvements in haemoglobin, ferritin, soluble transferrin receptor and body iron among female Indian tea pickers in a period of nine months . DFS has been evaluated in the controlled trials in tribal communities and in residential schoolchildren in both urban and rural setting with positive impacts.
Fortification of edible oil with vitamin A and D is technically feasible, well proven, and established in India. 70-88 percent of vitamin A was recovered even after 30 days from open pails exposed to light and air at the Indian ports. During Indian cooking as well the levels have been found to be stable. When oil was added to mixture of rice, beans and pulsesfor Indian feeding programs, around 93 percent of vitamin A was retained after 15 minutes and 90 percent after 30 minutes of cooking . Even with deep frying pakoras in vanaspati at 200º C, retention ranged from 71% after 5 minutes, to 41% after 15 minutes .The stability of Vitamin D is found to be similar to that of vitamin A as little or no loss is reported during processing or storage .
Consumption of fortified milk by children in India has shown encouraging results. Studies suggest that the intake not only increased mean serum Vitamin D levels but also morbidity rates were decreased (18 percent lower incidence of diarrhoea, 26 percent lower incidence of pneumonia, 7 percent fewer days with high fever and 15 percent fewer days sick with severe illness). There is ample evidence from our country which shows that fortification of milk with Vitamin A and D is an effective and safe strategy to reduce related deficiency diseases
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