Strengthening food fortification in Pakistan

Since its birth, Pakistan is facing the problem of some basic nutrients in daily diet for majority of population that make us a under nourished nation. Pakistan Pure Food act (1956) was perhaps the first one that addresses the problem of malnutrition through legislation. This act stresses the inclusion of vitamins A,D,E & K in oil and fat product. With passage of time there evolved several strategies to cope with Iodine deficiency in the nation, that is associated with mental retardation, goiter and several other ailments. Later on country wittnessed several other programs with the assistance of UN, WFP and some other global organizations to deal the problem of micronutrients deficiences.

National Nutrition survey indicated some better situation with regard to micronutrient deficiencies, where iodine status had improved nationally, but vitamin A status had deteriorated and there had been little or no improvement in other areas linked to other micronutrient deficiencies. More than half of the children under five years of age and more than 40 per cent of non-pregnant women were suffering from Vitamin A deficiency (NNS,2011). Deficiency of vitamin A cause Night blindness. Nutrition survey

indicated that 16% pregnant women suffered from night blindness. About 40% of women and children were deficient in zinc, and 70% of pregnant women and 40% of children were deficient in vitamin D. Moreover, persistent high rates of stunting (44%) and wasting (15%) among children under 5 are an important reminder that this could be a major bottleneck in addressing child survival in Pakistan.Almost similar condition prevails for vitamin "D" deficiency. About 40 per cent children under the age of five and 66 per cent women of reproductive age were vitamin D deficient in Pakistan. One in five pregnant and lactating women and one in three children under the age of 5 are anemic due to iron deficiency. Zinc deficiency is also highly prevalent in Pakistan. Food insecurity in terms of nutrients is one of the reason for all of these nutrients deficiencies among the masses.The NNS 2011 indicated that 58.1% of households were food insecure nationally.

According to National Nutrition Survey (NNS) 2011:

"The National Nutrition Survey 2011 indicates that stunting, wasting and micronutrient malnutrition are endemic in Pakistan. These are caused by a combination of dietary deficiencies; poor maternal and child health and nutrition; a high burden of morbidity; and low micronutrient content in the soil, especially iodine and zinc. Most of these micronutrients have profound effects on immunity, growth, and mental development. They may underlie the high burden of morbidity and mortality among women and children in Pakistan. Increasing rates of chronic and acute malnutrition in the country is primarily due to poverty, high illiteracy rates among mothers and food insecurity. Such rates can also be attributed to inherent problems in infant feeding practices and lack of access to the ageappropriate foods."

Food fortification is safe and cost-effective technique in the prevention of micronutrient deficiencies and has been widely practiced in developed countries for well over a century. Large-scale fortification with essential vitamin and minerals in wheat flour, edible oil and ghee is the key to improving nutrition.

Government should take the initiative for these purposes and framing legislation at national and provincial levels. Private sector should also take the lead in these areas in which fortification initiatives could be pursued include:  Wheat flour fortification by small-scale Chakki millers  Fortification of commercial complementary foods for infants and young children  Fortification of dairy foods etc. The role of Universities and research institutes is also vital to develop new technologies to combat this problems. Development of new departments in discipline of Nutrition and Food technologies across the Pakistan will be helpful to create intelligent and technical sound work force. These initiatives are in accordance to Higher Education Commission (HEC) Plans and Millenium Development Goals (MDG).