Abstract：
The slow improvement in micronutrient malnutrition globally and in India warrants a need for scaling-up scientifically proven, cost-effective public health interventions. The present review discusses the potential of staple food fortification as a complementary strategy to tackle micronutrient deficiencies, while addressing the current concerns raised regarding its implementation. The review indicates the below par status of current strategies like dietary diversity and supplementation to address multiple micronutrients deficiencies in India and the need for complementary strategies to tackle this problem. Based on systematic reviews and meta-analysis, global and national evidence has identified staple food fortification as a proven and recognized cost-effective solution to address micronutrient deficiencies. The Government of India has shown a strong leadership to promote this proven intervention. Further, the paper addresses the concern that large-scale staple food fortification (LSFF) may lead to excessive nutrient intakes when delivered together with other interventions, e.g., supplementation, dietary diversity, among the same populations. A key message that emerges from this review is that LSFF is safe with current dietary intake and deficiencies and low coverage of other interventions. Given the current situation of food and nutrition insecurity which the COVID-19 pandemic has further exacerbated, and the critical role that nutrition plays in building immunity, it is even more important that health and nutrition of the population, especially vulnerable age groups, is not only safeguarded but also strengthened. LSFF should be implemented without any further delay to reach the most vulnerable segments of the population to reduce the dietary nutrient gap and prevent micronutrient deficiencies. Effective monitoring and regular dietary surveys will help ensure these interventions are being deployed correctly.
摘要：
全球和印度微量营养素营养不良的缓慢改善，需要科学证明，具有成本效益的公共卫生干预措施。本综述讨论了主食强化作为解决微量营养素缺乏的补充策略的潜力，同时解决了当前对其实施提出的关切。审查表明，目前的策略，如膳食多样性和补充，以解决印度的多种微量营养素缺乏，以及需要采取补充策略来解决这一问题。基于系统评价和荟萃分析，全球和国家证据表明，主食强化是解决微量营养素缺乏的一种行之有效和公认的具有成本效益的解决方案。印度政府在促进这一行之有效的干预方面表现出了强有力的领导作用。Further,本文解决了大规模主食强化（LSFF）与其他干预措施一起提供时可能导致过量营养摄入的担忧，例如，补充,饮食多样性，在相同的人群中。从这篇综述中得出的一个关键信息是，LSFF在目前的饮食摄入和不足以及其他干预措施覆盖率低的情况下是安全的。鉴于目前粮食和营养不安全的情况，COVID-19大流行进一步加剧了这种情况，以及营养在建立免疫力中的关键作用，更重要的是，人口的健康和营养，特别是脆弱的年龄组，不仅得到保障，而且得到加强。应毫不拖延地实施LSFF，以覆盖人口中最脆弱的人群，以减少饮食营养差距并防止微量营养素缺乏。有效的监测和定期的饮食调查将有助于确保这些干预措施得到正确部署。
