As long as the poor remain malnourished, the malnourished will remain poor. Calorie deficits lower worker productivity, which in turn affects national output by as much as 4%. The government enacted the Food Security Act to alleviate hunger in India, a country with more hungry people than sub-Saharan Africa. But the Act only deals with the provision of macronutrients??staple food? like wheat and rice serve to provide calories?and doesn?t guarantee nutrition. Malnourishment, or the lack of vital micronutrients, in pregnant women?s diets results in low birth weights, which, in turn, affect the growth, susceptibility to chronic illnesses and learning abilities of their children. And here starts the cycle.
Of the two key minerals associated with development of learning, iodine and iron, the government has undertaken measures to fulfil iodine requirements by fortifying a commodity used by every household?salt. The initiatives for iron, however, are still in the works. With as much as 70% of India?s children classified as anaemic, these measures must be prioritised. Vinita Bali, MD and CEO of Britannia Industries believes that the right to nutrition is not only a social and economic imperative but also a moral responsibility. India?s competitive edge lies in its human capital, creating a critical need to invest in the right kind of nutrition. Bali spoke to Nikhila Gill and Jaya Jumrani on the eve of the Britannia Nutrition Foundation?s (BNF?s) symposium on creating awareness and affecting change through its initiatives. Excerpts:
The foundation?s charter outlines that it aims at effecting policy change using the company?s widespread network. What are the initiatives undertaken?
The initiative is what we have now. We can invite policymakers, NGOs, individuals and institutions in the nutrition space to a forum, where we can have an open dialogue on the problems and possible solutions. And this is exactly what we?re doing through this symposium.
China has fortified soy sauce, Thailand has fortified rice, Uganda has cooking oil. India, however, has only worked with iodine. What is your view on genetically fortifying foodgrains?
These two issues have to be looked at separately. I cannot make the decision to fortify flour.
I can decide to fortify what I am producing. I have decided that and implemented it. The rest of it is in a larger ecosystem and regulatory framework, which has to be worked on by the people responsible for that aspect.
Are conversations on the subject already taking place?
They have been happening for a long time. The question though is what action is being taken. Ultimately, each sector is responsible for its own initiatives?the government has to do what the government can do, the NGOs have to do what the NGOs can do and so on. To this end, I do not want to take on others? roles. But I think, coming together to understand and address the problem and use good governance to delegate work and making things happen is what we have to strive for.
The BNF has worked with the Navjyoti Foundation to provide fortified Tiger biscuits to anaemic children. Iron, however, can only be absorbed in the presence of additional micronutrients. How do you judge its bioavailability? And what were the results of this study?
We set up a field-experiment to monitor the haemoglobin levels of underprivileged children at the Navjyoti Foundation. A panel of nutritionists and paediatricians determined the children?s initial levels of haemoglobin to be at a low 7-8. After determining the iron intake required, the children were then given four fortified biscuits for 90 days. At the end of the 90 days, their haemoglobin levels had risen significantly to between 11 and 12. We assessed the bioavailability of iron since there is no point producing food that has components not available to the body.
Is this the same discussion as that on hunger?
It is important to keep in mind that, for example, when I eat rice, it is a macronutrient. Just because it fills my stomach, this doesn?t mean that it gives me all the nutrients I need for my growth and development. People from affluent backgrounds can afford to supplement their food with multivitamin pills and so on. But supplementation and diversification (eating various vegetables and fruits) is not available to poor people.
Since this measure demonstrably works, let?s examine costs. The cost is roughly Rs 100 per child?you gave the Navjyoti kids 4 biscuits a day that cost 27 paise each for 90 days to get their haemoglobin levels up. India has roughly 25 crore anaemic kids?70% of the 35 crore in the 0-14 age group. So that?s a project of just Rs 2,500 crore, a very small sum for such large impact. What measures should be implemented to increase the scope of such projects?
A widespread effort has to come from a number of different quarters. This is why we plan to have a number of speakers sharing a much larger perspective in today?s seminar on nutrition. The first issue at hand concerns the quality of food we eat and how diluted it is in terms of its nutritive value. The second concerns the quantity of food. In addition to the macronutrients, are we getting enough micronutrients?
How do we get kids to eat more spinach, which is rich in iron?
If I need to increase my iron intake, I must eat a lot of spinach. But since not all the iron from spinach is bioavailable, I can look at other measures?fortification, supplementation and diversification. In the short term, fortification is the easiest form of intervention. Why is it that one doesn?t see such pervasive anaemia in North America and western Europe? It is because all their package food is fortified with micronutrients? We?ve seen such legislation in our country before?with one legislation, iodine was made mandatory in all salt.
So, this shows that agriculture, the government and fortification, all have a role to play. Even consumer awareness has a role to play. Dieticians say ?eat fruits of all colours?, an easy way of saying diversify. But food has to be available at affordable prices.
Do you see an upcoming Right to Nutrition Act in the near future?
I just want the right to nutrition. If an Act or legislation is going to get it, then so be it. If a concerted action can get it, then let it be so. The right to nutrition should be a fundamental right.
How optimistic are you about the attainability of the UN millennium development goals (MDGs)?cutting proportion of the world?s hungry people in half?
Although we are currently falling behind on our nutrition MDGs, we have to keep trying and keep pushing. We cannot give up until we achieve these goals.