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Relevance: GS-II (Health & Social Justice) | GS-III (Science & Tech) | Source: The Hindu
The Context: Under NFHS-5 (2019–21), 57% of Indian women and 67% of young children suffer from anaemia. To fix this quickly, states are pushing Double-Fortified Salt (DFS)—salt mixed with both iron and iodine. However, health experts warn that adding iron to everyday salt carries health risks, misses the right groups, and ignores the real causes of anaemia.
1. Why Double-Fortified Salt (DFS) Faces Criticism
- Clashes with Blood Pressure Goals: Indians already eat ~10g of salt daily—double the WHO limit of 5g—and 1 in 3 adults has high blood pressure. Promoting salt as a “healthy iron carrier” sends a confusing message when India is trying to cut salt intake.
- Reaches the Wrong Group: Adult men eat the most food (and salt) but need extra iron the least. Meanwhile, toddlers and pregnant women eat much less salt, meaning those who need iron the most get the smallest doses.
- Risk of Iron Overload (“Stacking”): The government already distributes iron-fortified rice through ration shops (PDS), school meals (PM POSHAN), and Anganwadis (ICDS), alongside iron pills. Adding iron-fortified salt on top risks giving people an unsafe, unmonitored overdose of daily iron.
- Gut & Infection Risks: The human body has no natural way to flush out extra iron. Unabsorbed iron stays in the gut, feeding harmful bacteria (causing diarrhoea) and worsening infections in malaria-prone areas.
- Danger to Thalassemia & Sickle Cell Patients: Millions of Indians (especially in tribal belts) carry genetic blood disorders like Sickle Cell Disease or Beta-Thalassemia. For them, consuming extra iron through mandatory food fortification can cause toxic organ damage.
2. Medical Reality: Anaemia Is Not Just Lack of Iron
- Beyond Iron Deficiency: The government’s own CNNS survey proved that less than half of childhood anaemia in India is caused by low iron. The rest comes from lacking Vitamin B12, Folate, and Vitamin A, alongside worm infections and poor overall diets.
- Diet Blockers vs. Boosters: Heavy cereal, millet, and pulse diets contain phytates (and tea/coffee contain tannins) that block plant-based (non-haem) iron absorption—whereas Vitamin C (citrus fruits, amla) helps the gut absorb it.
- How Infections Block Iron: When someone has constant infections (often from poor sanitation), the liver releases a hormone called hepcidin. Hepcidin shuts the gut’s door to iron, making extra iron in salt completely useless.
Practice MCQ
Q. Consider the following statements regarding anaemia and food fortification in India:
- Iron deficiency is the sole biological cause of all anaemia cases recorded among children and adolescents in India.
- Phytates present in cereal- and millet-rich diets bind with non-haem iron and reduce its absorption in the human gut.
Which of the statements given above is/are correct?
(a) 1 only (b) 2 only (c) Both 1 and 2 (d) Neither 1 nor 2
Answer: (b) 2 only
Hint: Statement 1 is incorrect because the CNNS survey proved that iron deficiency causes less than half of childhood anaemia cases—Vitamin B12/folate shortages, infections, and genetic disorders like sickle cell also play major roles. Statement 2 is correct; phytates in grains and tannins in tea block plant-based iron absorption, whereas Vitamin C boosts it.
Hint: Statement 1 is incorrect because the CNNS survey proved that iron deficiency causes less than half of childhood anaemia cases—Vitamin B12/folate shortages, infections, and genetic disorders like sickle cell also play major roles. Statement 2 is correct; phytates in grains and tannins in tea block plant-based iron absorption, whereas Vitamin C boosts it.
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