National food fortification: a dialogue with reference to Asia: balanced advocacy

The vulnerability of large segments of Asia's population to micronutrient deficiency is more a consequence of cultural evolution and demography than of economic inequities. We evolved in a hunter-gatherer lifestyle with vigorous energy expenditure, wide dietary variety and a nutrient-dense diet (meat, viscera), and wound up 10,000 years ago as agriculturalists cultivating cereal and tuber crops for 70% of our dietary calories. Obtaining rice, maize and wheat is less energy intensive than needed for hunters' fare, while grains are distinctly less rich in available vitamins and minerals. Recurrent infectious episodes, transmitted in crowded societies, further deplete micronutrient nutriture. A fast-track option to address historically unprecedented life conditions includes chemical- or bio-fortification of ubiquitous condiments or widely consumed staples. With little or no change in habitual eating individuals will consume recommended micronutrient intakes and uptakes. Generous intakes of nutrients such as vitamin A and zinc counteract the adverse environmental effects on quality of life and survival in poverty situations. One size may not fit all, and over-consumption of certain micronutrients in heterogeneous societies is to be avoided. For the rice bowl to support the descendants of the caveman in the third millennium requires both imagination and technological ingenuity.