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The Need for Food Fortification With Zinc in India: Is There Evidence for This?
Raghu Pullakhandam1, Bharati Kulkarni2, Anura V Kurpad3
1ICMR-National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, Telangana. Correspondence to: Dr Raghu Pullakhandam, Drug Safety Division, ICMR-National Institute of Nutrition, Jamai Osmania, Hyderabad, Telangana 500007. raghu_nin2000@yahoo.com.
Abstract:
There has been recent advocacy for food fortification with zinc in India. However, there are three important conditions that should be established before fortifying food with any micronutrient, which requires that there should be i) Established high prevalence of biochemical or sub-clinical deficiency (≥20%), ii) Low dietary intakes that increase the risk of deficiency, and iii) Evidence of efficacy of supplementation from clinical trials. For zinc, all three conditions are not satisfied. The prevalence of low serum zinc concentrations in Indian children is well below 20% (~6%), signifying that zinc deficiency is not a public health problem. There is no risk of dietary zinc inadequacy in Indian populations where intake has been measured. Finally, there is no robust evidence that zinc-fortified foods improve functional outcomes, even if the serum zinc concentration is increased. Thus, contemporary evidence does not justify the need for food fortification with zinc in India.
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