ArmInfo. The Ministry of Healthcare of Armenia believes that the enrichment of flour with micro-elements and vitamins is one of the most important measures to protect public health. Thus, the Ministry of Healthcare of Armenia did not abandon the resonant project on the enrichment of flour with folic acid and iron.
"Legislation on mandatory enrichment of wheat flour was adopted in 82 countries," the Ministry of Healthcare said in response to a request from ArmInfo. The goal is to compensate for the shortage of vitamins and micro-elements in a number of countries, to improve the health status of the population by correcting the deficiency of micro-elements in the diet, in particular, iron and folic acid in the quantities required in a full-fledged diet. The Ministry of Healthcare proceeds from the fact that micronutrients, including iron and folates, are not synthesized by the human body, and the only source for their production is human nutrition. In this regard, the Ministry of Health of Armenia notes the importance of raising the awareness of the Armenian population in this issue, holding public and expert discussions, and if funding is available, the need for additional laboratory research. As stated in the response to the request of Amrinfo, taking into account that the technical regulations of the EAEU do not envisage mandatory flour fortification as imperative, and according to the results of study of anemia in Armenia for 2015-2016 positive dynamics was observed, the Ministry of Health of Armenia, "will return to the revision of the legislation on overcoming the shortage in microelements after additional laboratory research and work on public awareness".
Enrichment as a panacea Hrayr Aslanyan, senior researcher at the National Institute of Health (NIH) of the Ministry of Health care of the Republic of Armenia, told ArmInfo that the recommended daily intake of folic acid is 400 ?g for an adult. Meanwhile, a person a day gets one tenth of the required minimum or a little more - up to one-fifth. As a result, according to statistics, in Armenia, neural tube defects (Spina bifida - hydrocephalus), which cause permanent disability among children, are 4 times higher than the number of such cases in countries where the legislative imperative for flour fortification is in force. At the same time, as Aslanayan pointed out, today there is no register of children with congenital defects in Armenia. According to Aslanyan, the problem of hidden hunger is often not related to the financial capabilities of citizens, and even well-to-do families have problems with malnutrition due to unhealthy diet. This is caused by both the specifics of the national cuisine, and the way of life of the Armenian population, which prefer not to visit doctor until the last fateful zero hour.
Does Healthcare Ministry guard interests or just want to follow the global trend? Artificial flour fortification with folic acid is the trend of the latest decades. The initiative belongs to the Food Fortification Initiative (FFI USA), consisting of 89 organizations, including WB, WHO, UNICEF and other major global institutions. Approximately 80 countries have legislation on wheat flour fortification, 12- corn flour, and 5 countries- rice. Flour enrichment is mandatory in 7 countries in Europe and Asia. Almost the entire Americas and Australia are involved in this program, in most countries of Eurasia (including China and India) flour is not enriched. The main additives are iron compounds and folic acid. Zinc, vitamins A, D and other B vitamins: nicotinic acid, thiamine, riboflavin, and cyanocobalamin can also be added According to FFI, each country decides for itself how much and which additives should be used by local mills. In 2014, Armenia also decided to follow the trend - the Government of Armenia approved the draft laws on Making Amendments to the RA Law on Enrichment of Wheat Flour and the Code on Administrative Offenses. According to the first draft, in flour mills of Armenia with a capacity of 30 tons and more high and first grade wheat flour should be enriched with premixes, that is, mineral and vitamin supplements. There are seven such mills in the republic (as of 2014). The flour they produce accounts for 80-85% of the total flour sold on the market. The initiator of the program is the United Nations Children's Fund- UNICEF. The Fund will provide free equipment and methodological knowledge. In the first year, the government will receive supplements for free, after which premixes, again with the assistance of UNICEF, will be purchased at market prices. According to the government, in terms of improving public health indicators, the effects of fortified wheat flour will manifest themselves in the next 3-5 years after the introduction of the program. Cardiovascular diseases are expected to be reduced by almost 10%, birth defects by 30-35%, and anemia in children and women by 25-30%. The second bill establishes penalties in the event of unenrichment or violation of requirements for the enrichment of high and first grade flour.
First off, do no harm
Local experts were anxious of the initiative. According to experts, Armenians are a people who consume bread in large quantities, and after products made of fortified flour are put into circulation, it will be difficult to control the amount of iron and folic acid consumed by humans, as well as how well these microelements are assimilated. Referring to international experience, they also stated that in a number of countries where the flour fortification process was launched, cases of oncological diseases of the large gut became three times more frequent. Many countries, including Russia, Austria, Germany, Israel, and Japan, abandoned the idea of enriching flour.
Calling to adhere to the principle of bioethics "Do no harm!", the expert community, and the majority of Armenian citizens said their decisive "no" to the project. However, as it turned out, the staff of the Ministry of Healthcare of Armenia did not abandon the intention to "enrich" wheat flour with iron microelements, as well as folic acid. As part of the initiative, in August 2017, the Government of Armenia approved a program of activities, the main purpose of which is to "raise the awareness of the Armenian population about the benefits of flour fortification". As it turned out, the new government did not abandon the mandatory enrichment initiative, waiting for zero hour.