New Delhi, Jul 30 (PTI) Healthcare experts have asked the government to exercise "extreme caution" in implementing new chemical interventions to address micronutrient deficiencies in India, saying it may do more harm than good.

The government is on course for adopting a policy on mandatory fortification of foods, including rice in the social safety network programs, following up the one notified in 2018, which was voluntary, the experts said.

Asking for exercising extreme caution in implementing new chemical interventions to address micronutrient deficiencies in India, experts warn that it may do "more harm than good".

"Why this caution? First, putting more of the same thing may not be effective and second, if intake is in excess because of double layering of iron intake, it may do more harm than good. According to the scientific studies published in reputed international journals increasing the iron intake alone has no impact and cannot replace the dietary diversity. It is the dietary diversity that facilitates the uptake of iron for the body," the experts said in a joint statement.

One, the prevalence of anaemia is magnified because of the use of inappropriate haemoglobin cut-offs to diagnose the malady in children and pregnant women, said Professor Anura Kurpad, Department of Physiology, St. John's Medical College, St. John's National Academy of Health Sciences, Bengaluru.

It creates an ongoing perception of a stagnant or worsening anaemia prevalence, however, it does not reflect the true nutritional status of a population. Thus, the cure proposed may not even make any impact on their (magnified) status of micronutrient deficiency, he added.

"Another factor that adds to this perception of stagnancy is the method of measurement of haemoglobin, which again inflates anemia prevalence. In the surveys, haemoglobin values are measured through capillary blood rather than the venous blood, which is fallacious, since the haemoglobin concentration in these two samples can differ by as much as 1 g/dL. This in fact creates much more potential for misclassification when the population has an average haemoglobin value that is close to the diagnostic cut-off for anaemia," he said.

"It is also important to take note of the evidence that shows that women who have been consuming iron in excess can have adverse effects on fetal development and birth outcomes, with adverse modifications of the healthy microbiome, and increased risk of chronic diseases. Since the intervention of iron or fortification is not being monitored, no evidence is generated on its benefit or safety; such a policy is not justified," he added.

According to Professor HPS Sachdev, Sitaram Bhartia Institute of Science and Research, New Delhi, "The fortification expenditure of only the rice delivered through the social safety networks will cost the public exchequer about Rs. 2600 crores annually. In the backdrop of the already ongoing public health initiatives of iron supplementation, this represents an avoidable and wasteful expenditure with no palpable benefits, but on the contrary the risk of potential harm. The money would be better spent on alternative diet based sustainable solutions and improving the access to quality health care in the public sector”. EXPERTS-FORTIFICATIONZMN

(The above story is verified and authored by Press Trust of India (PTI) staff. PTI, India’s premier news agency, employs more than 400 journalists and 500 stringers to cover almost every district and small town in India.. The views appearing in the above post do not reflect the opinions of LatestLY)