Unless the intake of fluoride through food and water is reduced, tackling anaemia by providing iron folic acid tablets is a futile exercise, an expert says

Bangalore: The Health Ministry’s proposal to tackle anaemia by providing iron folic acid (IFA) tablets every week to 130 million adolescent girls across the country is not going to change things, an expert said.

“It is a repeat of the approach that faileanaed miserably even after 40 years of implementation,” Delhi-based Fluorosis Research and Rural Development Foundation Director AK Susheela said.

IFA supplementation to pregnant women visiting antenatal clinics was introduced in 1970 throughout the country, since anaemia in pregnancy leads to birth of underweight babies.

Susheela said she is surprised at the attempt to re-introduce this failed programme even though the ICMR is aware that taking IFA tablets does not help combat anaemia, unless the intake of fluoride through food and water is simultaneously reduced.

A survey by the Indian Council of Medical Research (ICMR) in 1986 found no change in the prence of anaemia and so, from 1992, the dosage of iron was increased from 60 mg to 100 mg. That too made no difference, the foundation said in a statement.

The current prence rate of anaemia is 80 percent in children and 70 percent in pregnant women.

Of India’s 35 states and Union Territories, 19 are “endemic” areas for fluorosis, the main cause being fluoride-laden water derived from deep bore wells.

“The chemical fluoride not only decreases production of red blood cells by the bone marrow but also destroys microvilli – the microscopic protrusions lining the intestine – resulting in poor absorption of nutrients critical for the biosynthesis of haemoglobin,” Susheela, a former Anantomy Professor at AIIMS   explained.

The foundation, in a letter to NRHM director Auradha Gupta, cautioned that IFA supplementation is an “inappropriate and unscientific manner of addressing anaemia and an absurdly futile exercise.”

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