Hidden hunger horrors: Indonesia needs more mandatory food fortification to address triple malnutrition threat – expert insights

23-Sep-2024 - Last updated on 23-Sep-2024 at 05:47 GMT

Indonesia will need to implement more mandatory food fortification in staple foods if the country hopes to address its serious triple malnutrition threat. ©Getty Images

Indonesia will need to implement more mandatory food fortification in staple foods if the country hopes to address the serious triple malnutrition threat that it currently faces, according to local food industry experts.

At present, Indonesia has already mandated the fortification of three types of staple foods, namely salt (with iodine), wheat (with iron) and edible oils (with Vitamin A) – but local data has indicated that many challenges still lie in the way of these effectively addressing malnutrition issues.

“Each of these three fortification programmes have faced their own hurdles that have seriously challenged their effectiveness thus far,” IPB University International Food, Nutritioin and Health Research Institute Head Professor Dr Drajat Martianto told the floor at the recent Fi Asia Conference as part of the Fi Asia 2024 event in Jakarta, Indonesia.

“For salt, the main issue has been hitting the desired target of covering at least 90% of households with iodised salt, as although improvement has been observed the achievement is still below 80%.

“For cooking oil, Indonesia’s main oil of choice is palm oil, and this comes as either branded or bulk palm oil (minyak curang) – so while branded oil can be fortified quite easily, the issue is ensuring that the bulk palm oil is as well as over 75% of poor households use this for their cooking.

“And for wheat, we have the issue of gathering academic proof that fortification is effective as very few studies are available in this areas to evaluate effectiveness, and it has also been unstable as over the past two decades wheat fortification has been going back and forth between being mandatory and not mandatory – though currently it has been mandatory since 2020 due to COVID-19.”

Prof Drajat added optimistically that food technology improvements and relatively low costs mean that more mandatory food fortification is on the way, stressing that it will be a crucial strategy to help Indonesia solve malnutrition despite all the challenges being faced currently.

“Indonesia is a big country and malnutrition needs to be addressed on a large scale, so large scale food fortification is the most important strategy to be implemented, most crucially because it is actually the cheapest possible solution and Indonesia requires the most cost effective way forward possible,” he said.

“We face a triple malnutrition threat in this county, namely overnutrition, undernutrition and micronutrient deficiency which is also known as hidden hunger, and the last is what food fortification can help to address.

“It is only when this micronutrient deficiency is addressed that we can expect the physical capacity of the public to improve, which in turn would help improve incomes and workforce and economic development.

“But in reality, there are many micronutrient deficiencies that still need to be addressed here – our data shows that some of the biggest insufficiencies are Vitamin B9 or folic acid (96.78% of population), zinc (74.98%) and Vitamin A (59.07%).

“Even more concerningly, this is happening not only amongst lower socioeconomic classes but is also observed even in urban populations that have access to more nutritious foods, which is why mandatory fortification would be able to help with accessibility of these micronutrients.”

Energy vs nutrition

Prof Drajat also highlighted that many Indonesian consumers are currently only adhering to an energy-sufficient diet that meets caloric needs for short term subsistence, but few are actually getting nutritious diets that meet the required amount of essential nutrients, much less healthy diets that include a diverse range of food groups.

“The main reason for this is none other than cost, because we have found that healthy diets (estimated at IDR14,149 / US$0.92 per capita) meeting Indonesia’s Food Based Dietary Guidelines are actually estimated to cost some 66% more than even nutritious diets (IDR8,532 / US$0.55), let alone energy-sufficient ones (IDR3,392 / US$0.22),” he said.

“This puts non-affordability of healthy diets at 48% to 57%, nutritious diets at 12% and energy-sufficient diets at less than 1%, which is why so many Indonesians just go for the latter.

“It is not that people do not want to eat healthy, but that they simply are not able to afford to buy foods in this healthy diet.”