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<div dir="ltr" data-setdir="false">It is misleading to say only that fortifying rice with iron has no effect on anemia. That is rarely if ever the goal, keeping in mind that half or more of anemia is usually not related to iron deficiency. </div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">More relevant, but not mentioned below, is that the Cochran review found that iron fortified rice may reduce iron deficiency and increase mean hemoglobin. In my experience, when it does not have an impact on hemoglobin, it usually does have an impact on serum ferritin or storage iron, which is not reported on in the Cochran review.</div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">Many countries now fortify wheat or maize with iron and folic acid (to prevent neural tube defects). In a heavily rice eating population (which includes many countries in LA and Africa and most of Asia), this approach misses the opportunity offered by doing the same with rice--which is rarely fortified today. </div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">The simpler approach for fortifying rice (cold extrusion) increases the cost by about 3%, far less than normal market price fluctuations. Much of the global donor community is instead mainly promoting the much more costly and extremely complex hot extrusion method owned by DSM--who also gave WFP one million dollars to use their technology. </div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">Regards,</div><div dir="ltr" data-setdir="false"><br></div><div dir="ltr" data-setdir="false">Ted Greiner</div><div><br></div>
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On Wednesday, December 4, 2019, 09:02:16 AM GMT-3, Claudio Schuftan <cschuftan@phmovement.org> wrote:
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<div><div id="ydpccc54042yiv8169604726"><div dir="ltr"><div class="ydpccc54042yiv8169604726gmail_default" style="font-size:large;"><br></div><span style="font-family:-webkit-system-font, Helvetica Neue, Helvetica, sans-serif;"><b>From: </b></span><span style="font-family:-webkit-system-font, Helvetica Neue, Helvetica, sans-serif;">Sylvia Karpagam <<a href="mailto:sakie339@gmail.com" rel="nofollow" target="_blank">sakie339@gmail.com</a>><br></span><div class="ydpccc54042yiv8169604726gmail_quote"><div><div><div><blockquote type="cite"><span class="ydpccc54042yiv8169604726gmail_default" style="font-size:large;">excerpts</span><br><div><div><div dir="ltr"><div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">The Eat<i> Lancet</i> Commission report, <span style="color:blue;text-decoration-line:underline;"><a href="https://www.fssai.gov.in/eatlancetindia/" style="color:blue;" rel="nofollow" target="_blank">launched</a></span> on April 4,
2019 the at the Food Safety and Standards Authority of India (FSSAI)
headquarters, New Delhi, India had its premise on the question “<i>Can we feed a future population of 10
billion people a healthy diet within planetary boundaries?’</i>. The event
aimed to ‘<i>spark conversations’</i> among
all stakeholders and deliberate on the five global strategies to bring about
the <i>‘Great Food Transformation’</i>.</span></div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><b><u><span style="font-family:New serif;"><span style="text-decoration-line:none;"> </span></span></u></b></div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><b><u><span style="font-family:New serif;">Eat-Lancet
‘stakeholders’</span></u></b></div><b><u><span style="font-family:New serif;"><span style="text-decoration-line:none;"> </span></span></u></b><p class="ydpccc54042yiv8169604726MsoNormal" style="text-align:justify;line-height:normal;margin:0cm 0cm 8pt;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">Neither of the two ‘experts’
representing India on the Eat <i>Lancet</i>
commission have any experience or expertise on nutrition. The alacrity with which FSSAI is ready to promote and project the EAT
Lancet report does away with all democratic consultation processes and allows
for unilateral decisions with ‘equal stakeholders’ such as companies,
corporates and students. That the Right to food campaign, which has been a
consistent proponent of food security and a vocal critic of fortification and industry,
has been left out from the report release shows the tilt of the FSSAI towards
commercialising food in India. </span></p><span style="font-family:New serif;">It
is of concern that neither the Eat <i>Lancet</i>
group nor their government supporters in India, have taken any cognisance
either of the research or the recommendations by the National Institute of
Nutrition (NIN), the 100 year old government nutrition research body in the
country. Is it because the evidence from NIN strongly points in favour of
animal source foods?</span><div style="text-align:justify;margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;"> </span><br></div><p class="ydpccc54042yiv8169604726MsoNormal" style="text-align:justify;margin:0cm 0cm 8pt;line-height:107%;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">The
Eat <i>Lancet </i>report has been<span style="color:blue;text-decoration-line:underline;"><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31903-8/fulltext" style="color:blue;" rel="nofollow" target="_blank">
critiqued</a></span> for methodological flaws in assumptions,
data collection and modelling, substantial enough to alter the conclusions of
the report.</span><span style="font-family:New serif;color:rgb(80,80,80);"> </span><span style="font-family:New serif;">They
observe that some of the described relative risks, such as the association
between red meat and type 2 diabetes do not match the values in the source
studies or were based on a different definition of meat consumption (e.g.
conflating effects from red and processed meat)
</span><span style="font-family:New serif;"></span></p><span style="font-family:New serif;"> </span><span style="font-family:New serif;"></span><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">Some observations about the Eat
Lancet report </span></div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><b><u><span style="font-family:New serif;"><span style="text-decoration-line:none;"> </span></span></u></b></div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><b><u><span style="font-family:New serif;">On
diet related morbidity and mortality</span></u></b></div><p class="ydpccc54042yiv8169604726MsoNormal" style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;"> </span></p><span style="font-family:New serif;">The
report, by clubbing undernutrition and obesity as ‘low dietary quality which
causes persistent micronutrient deficiencies’, fails to take into account the complexities
around nutrition in India.</span><p class="ydpccc54042yiv8169604726MsoNormal" style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;"> </span></p><br><span style="font-family:New serif;"> </span><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">The
report claims that ‘<i>traditional diets’</i>
in countries like India include <i>‘little
red meat which might be consumed only on special occasions or as minor
ingredients of mixed dishes’</i>. In India there is a vast difference between
what people would like to consume and what they consume in reality because of
innumerable barriers around caste, religion, culture, cost, geography etc. The
report feeds into the false premise that a majority of people in India consume
less meat by choice.</span></div><p class="ydpccc54042yiv8169604726MsoNormal" style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;"> </span></p><b><u><span style="font-family:New serif;">Taxes and subsidies</span></u></b><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">They
make dangerous recommendations that ‘<i>food
prices should fully reflect the true costs of food. Subsidies on fertilisers,
water, fuels, electricity, and pesticides should be critically reviewed, with
some authorities arguing for their removal, and environmental and societal
health costs of food supply and consumption should be fully reflected in
pricing by introducing taxes. As a result, food prices might increase”.</i>
Increase in food costs would be the death knell for small farmers in India who
are already reeling with loans they are unable to repay and an increase in food
prices would be death knell for the poor in India who have chronic energy
deficiency, stunting, undernutrition, anemia and a host of other vitamin and
mineral deficiencies.</span></div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">The
solution offered by the Eat Lancet group is ‘<i>Therefore, where appropriate, social protection or safety nets (e.g.,
increasing income through cash transfers) can be established to protect
vulnerable populations, particularly children and women, while keeping trade
open</i>” Keeping ‘trade open’ and
‘protecting vulnerable populations’ do not go hand in hand. The market has been
relentless in its greed and pretending to have a social goal is blatantly
flawed.</span></div><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">Cash
transfers have <span style="color:blue;text-decoration-line:underline;"><a href="https://www.governancenow.com/views/interview/interview-jean-dreze-development-economist" style="color:blue;" rel="nofollow" target="_blank">failed
miserably</a></span> in India and it only shows the level of marketization that
the ill-informed Eat lancet Commission is pushing for.</span></div><p class="ydpccc54042yiv8169604726MsoNormal" style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;"> </span></p><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><b><u><span style="font-family:New serif;">Conflict
of interest</span></u></b></div><p class="ydpccc54042yiv8169604726MsoNormal" style="text-align:justify;line-height:normal;margin:0cm 0cm 8pt;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;">The <span style="color:blue;text-decoration-line:underline;"><a href="https://www.efanews.eu/item/6053" style="color:blue;" rel="nofollow" target="_blank">conflict of Interest</a></span> of the
Eat Lancet Commission is too blatant to ignore. It was founded by Gunhild
Stordalen, an animal rights activist and one of Europe’s richest and whose
supporters include companies that develop fake meat and dairy. The underlying <span style="color:blue;text-decoration-line:underline;"><a href="https://www.efanews.eu/item/6053" style="color:blue;" rel="nofollow" target="_blank">agenda</a></span>
seems to be to use cheap plant based materials such as protein extracts,
starches and oils to market a ‘plant based lifestyle’ through a network of
large multinationals. </span></p><div style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;letter-spacing:-0.05pt;">FSSAI has been embroiled in controversies and
blatant </span><span style="color:blue;text-decoration-line:underline;"><span style="font-family:New serif;letter-spacing:-0.05pt;"><a href="https://www.outlookindia.com/website/story/opinion-conflict-of-interest-impairs-tie-ups-between-food-industry-and-its-regulator/339118" style="color:blue;" rel="nofollow" target="_blank">conflict
of interest</a></span></span><span style="font-family:New serif;letter-spacing:-0.05pt;"> with its scientific panel being populated with
‘experts’ from the food and beverage industry. </span></div><p class="ydpccc54042yiv8169604726MsoNormal" style="margin:0cm 0cm 0.0001pt;text-align:justify;line-height:normal;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;color:rgb(87,85,83);letter-spacing:-0.05pt;"> </span></p><p class="ydpccc54042yiv8169604726MsoNormal" style="text-align:justify;line-height:normal;margin:0cm 0cm 8pt;font-size:11pt;font-family:Calibri, sans-serif;"><span style="font-family:New serif;letter-spacing:-0.05pt;">Global Alliance
for Improved Nutrition (GAIN) which co-hosted this event are pushing for large
scale </span><span style="color:blue;text-decoration-line:underline;"><span style="font-family:New serif;letter-spacing:-0.05pt;"><a href="https://www.gainhealth.org/resources/reports-and-publications/national-mandated-food-fortification-programs-chapter-food" style="color:blue;" rel="nofollow" target="_blank">fortification</a></span></span><span style="font-family:New serif;letter-spacing:-0.05pt;"> of grains/oils
which FSSAI is promoting on a large scale such that it will </span><span style="color:blue;text-decoration-line:underline;"><span style="font-family:New serif;letter-spacing:-0.05pt;"><a href="https://www.downtoearth.org.in/news/food/fortified-rice-scheme-to-create-rs-3-000-crore-market-for-just-five-big-firms-66761" style="color:blue;" rel="nofollow" target="_blank">benefit</a></span></span><span style="font-family:New serif;letter-spacing:-0.05pt;"> 5 big international firms. This large scale
fortification has been criticised widely. A </span><span style="color:blue;text-decoration-line:underline;"><span style="font-family:New serif;letter-spacing:-0.05pt;"><a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009902.pub2/full" style="color:blue;" rel="nofollow" target="_blank">Cochrane
review</a></span></span><span style="font-family:New serif;letter-spacing:-0.05pt;"> shows </span><span style="font-family:New serif;">that fortification of rice makes little or no
difference to addressing anemia or Vitamin A deficiency.</span><span style="font-family:New serif;letter-spacing:-0.05pt;">. </span><span style="font-family:New serif;">The body requires a combination of
good quality proteins, minerals, vitamins and fats. Instead of addressing
chronic hunger and malnutrition through enabling better foods that include
meats, milk, eggs, dairy products, fruits and vegetables, that will
automatically address issues of malnutrition and micronutrient deficiency, the government is opening the door for
company dependent solutions. </span><span style="font-family:New serif;">What is not being disclosed or discussed is the cost of fortification,
the environmental or economic cost of shifting tonnes of micronutrients from
Western countries on a permanent basis because local food economies would have
been completely destroyed by this model. </span><span style="font-family:New serif;"></span></p><b><font size="4"><font face="georgia,serif">Dr. Sylvia Karpagam</font></font></b><div dir="ltr"><div dir="ltr"><div><div dir="ltr"><font size="2" face="georgia, serif"><a href="https://independent.academia.edu/SylviaKarpagam" rel="nofollow" target="_blank">https://independent.academia.edu/SylviaKarpagam</a></font><br>-- <br></div></div></div></div></div></div>
Jan Swasthya Abhiyan (JSA) is the Indian Chapter of the People's Health Movement. JSA brings together organisations and individuals in India working to promote health equity across all population groups. Also visit our website: <a href="http://www.phmindia.org" rel="nofollow" target="_blank">www.phmindia.org</a><br>
--- <br></div></div></blockquote></div><br></div></div></div></div></div>_______________________________________________<br>PHM-Exchange People's Health Movement<br>- To post, write to: <a href="mailto:PHM-Exchange@phm.phmovement.org" rel="nofollow" target="_blank">PHM-Exchange@phm.phmovement.org</a><br>- To view the archive, receive one weekly posting with all the week's postings, edit your subscription's options or unsubscribe, please go to the PHM-Exchange webpage: <a href="http://phm.phmovement.org/listinfo.cgi/phm-exchange-phmovement.org" rel="nofollow" target="_blank">http://phm.phmovement.org/listinfo.cgi/phm-exchange-phmovement.org</a><br></div>
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