Nutrition is a poorly understood concept in India. The percentage of our fellow citizens, who are correctly nourished, is quite small. As per a survey conducted by WHO India– ICMR, about 24% of urban and 41% of rural Indians never eat vegetables and about 48% of urban and rural population eats them only 1-3 times per week. This is noteworthy as fruits and vegetables comprise the major source of soluble dietary fibres, antioxidants, health enzymes, and several beneficial phytonutrients.
Demand Side Levers
The imbalances in nourishment pattern give rise to three broad categories of people: Over-nourished (~80 million); under-nourished (~380 million) and nourished with regard to calories but not nutrients (~570 million). The population below the poverty line is considered undernourished irrespective of their calorie intake. Similarly, people who consume less than 175 gm of fruits and vegetables per day have been considered deficient in micronutrients.
The above backdrop provides a sense of the enormity of India’s nutrition challenge and helps set the stage to understand the role that a developed nutraceutical sector can play in addressing this grand challenge. Proper nutrition underpins the abilty of our country to utilise her much talked about ‘demographic dividend’ for driving inclusive and sustainable prosperity and all other accoutrements that accompany this noble aspiration. Thus India urgently needs to create a well-developed and widespread nutrition eco-system that allows her citizens across the economic spectrum to access quality assured nutrients with which to supplement their current diets. As the wellness quotient of the average citizen improves, the benefits will be starkly visible through gains in productivity and reduction in healthcare costs. As we all know, the cost to cure is always much higher than the cost to prevent.
Compared to the need as described, the current size of the Indian nutraceutical market is miniscule and represents only ~2% of the global market. Given the acute economic heterogeneity and large size of the Indian population, per capita based comparisons serve limited purpose. Moreover, industry players have focused only on the large urban population centres and so with a miserable market penetration of less than 10%, nutraceutical products are available to only a few economically stable and relatively enlightened consumers who are aware of the interdependence between nutraceutical products, wellness and lifestyle related diseases.
Supply Side Levers
Nutrition science has established the importance that food plays in ensuring health and wellness. There is a growing understanding of the relationship between macro-nutrients, micro-nutrients and phyto-nutrients present in our food and the health benefits that they offer. As an example, we are beginning to define not only the quantitative but also the qualitative aspects of proteins that we need. Another illustration is the manner in which we have understood the negative impact of ingredients such as trans-fats and the positive impact of fats that contain omega 3 fatty acids. We have a decent understanding of the role and need for vitamins and minerals and the adverse effects caused by a deficiency. These have been used to prepare international and national guidelines for recommended daily allowance (RDA) for such products.
If we take a step back and reflect on the source of most of our nutrition, we find ourselves in the farm sector. So agriculture related challenges will impact the quality of nutrition that we get, even if we consume everything that our nutritionist ordered. For example, if a soil is low in zinc, then the grains and vegetables grown in that soil will contain lower amounts of zinc. To the consumer, zinc enriched dietary supplements provides one remediation as does the complex and more protracted effort of ensuring that the grain or vegetable has been grown in soil that has all necessary macro and micro-nutrients.
India is a biodiversity hotspot; there are supposed to be more than 18,000 traditional foods that have evolved over thousands of years. Additionally she possesses a large repository of traditional wisdom in nutrition and food science and technology. These two platforms if combined and used with modern science and technology can provide the variety of solutions that this most critical sector needs. Innovation, science and technology can be used to convert this tacit wealth of knowledge and wisdom into modern and contemporary food forms that are modern in look and feel, geographically sensitive, nutritionally balanced and without a taste penalty.
This natural bio-diversity provides a great source of competitive advantage and the nutraceuticals sector can play a crucial role in scientifically and selectively reviving traditional food habits to make balanced nutrition a realistic option for all. For example, dry land cereals such as bajra, jowar and ragi are now known to be better than wheat and rice in providing higher levels of proteins, fibres and minerals. Similarly, phyto-nutrient rich spices used in every day Indian cooking are great natural nutraceuticals. The fact that just 2-3 tea spoons of Moringa leaf powder can provide a large percentage of an adult’s daily Iron, Vitamin A, and Vitamin C needs, is largely unknown but can successfully be used to democratise the availability of such nutrients.
In recent times, we have also begun the journey to unravel the mysteries that shroud the functioning of the human gut, especially the manner in which the trillions of bacteria that populate the human gut influence our health and wellness. This is leading to a renewed respect for nutraceuticals such as prebiotics (e.g. Oligofructose or FOS and Oligogalactose or GOS) and their role in facilitating good gut health. A deeper understanding of human metabolic signatures and how these are modulated by the interplay between human gut microbes and human gut cells will help us develop a larger set of prebiotics and other nutraceuticals to enhance and fortify our foods and improve our health in a manner unprecedented till now.
At the core, consumers seek nutrition that is hygienic (objective criteria), optimum (objective criteria) and tasty (subjective criteria). Simultaneously, at the core, consumers deserve to understand the ‘know-how’ and more importantly, the ‘know-why’ of their nutritional choices. Based on these two core issues, the nutraceuticals sector, to achieve full potential in India, must focus on five key themes.
Nutraceutical players need to continuously share nutritional knowledge (built on good, authentic and transparent science) honestly and lucidly to enable consumers to make informed choices. Present day consumers are mindful of health and wellness issues: many believe that their dietary preferences can prevent the onset of many chronic diseases. As a result, food supplements are beginning to be consumed both for meeting recommended dietary allowances as well as for disease prevention. The communication also needs to be sensitive and true to the other recent consumer trend of higher reliance on natural and organic. If new knowledge comes to light which overturns earlier views, industry needs to make the consumer aware of this development; this has to be done with metronomic regularity.
Since time immemorial, people have eaten ‘local’ produce. It is only in relatively recent times after advances in sea faring global trade, that the definition of local has expanded to encompass food grown hundreds and thousands of miles away. The industry needs to invest materially relevant resources (e.g. 2% of turnover) in research and development to obtain a scientific understanding of the power of nature’s molecules as expressed in the form of phyto-nutrients available in the biotechnology park called India. They may build on ancient knowledge, but must follow the discipline associated with modern R&D to advance this knowledge. This is because, while nutrition science is universal, mass-market solutions need to be local. Omega 3 is an essential fatty acid and fish oil is the richest source of this fatty acid. For vegetarians, flax seed is a good source but this is present as ALA which therefore has to be converted to DHA by the body. This means there is need to find new plant sources of DHA. Hence India specific solutions offer the best option to address mass market need for health and wellness ingredients such as phyto-nutrients, vegetable proteins and dietary fibres. India is already a global source for many ingredients such as Curcumin, Guar Gum and Psyllium Husk; this list needs to be much longer and far more distinguished.
Taking a cue from the underlying spirit of the Food Security Act, balanced nutrition, rightly, is a need for all Indians irrespective of their economic standing. The nutraceutical industry has an opportunity to build innovative business models that include the community of farmers in a sustainable and virtuous economic value creating cycle. For example, it may lead to the realisation that compared to the tomato, the Gac fruit is a more cost-effective source of the antioxidant, Lycopene, and this in turn would facilitate preservation and growth of the Gac fruit industry. Overall, the sector presents a clear and present opportunity to utilise science and technology to meet a crucial consumer need in a manner that could become a model for benign capitalism. Additionally, it will help preserve biodiversity and that will have its own positive penumbra.
Even though the FSSAI Act was passed in 2006, the regulatory regime for the new category of food covered under Section 22 has not yet been formulated. The methodology for approving new products needs greater transparency and the total time for product approvals is uncertain. For foods that have been prepared with approved ingredients, is there at all a need for a separate approval and should one therefore only seek approval for novel food. There is consensus among nutraceutical companies that smart regulation related to quality and safety will benefit everyone and help wean out unscrupulous players who through their practices tarnish the image of the sector. Regulations need to be transparent and enforceable and decisions, timely. For this the nodal agency, FSSAI needs to be resourced far more richly in terms of skills, competencies and laboratory/field infrastructure. To this end, industry must engage with government to help make FSSAI more efficient and effective.
Trust and Interdependence
The nutraceuticals growth story requires public-private partnerships at multiple levels. The government will need to facilitate creation of intellectual capital and develop systems and processes that protect intellectual property and sovereign interests.
The three key stakeholders in the nutrition and food canvas are the consumer, the regulator (i.e. government) and the private enterprise. There is need to build mutual trust amongst these three stakeholders. Trust is the critical enabler that will allow India to fulfil her nutritional obligations not only to her own citizens but also to the world at large. Each of these three entities has a unique role to play in building this environment of trust. This will help converge government Acts and policies in the right manner and encourage a virtuous spiral of collaboration across entities. Apart from solving the nutrition challenge, the most valuable outcome of this trust is that it will have multiplier effects on enterprise creation and job creation, fuelled by science, technology and innovation. Finally, India’s unsung heroes, our farmers will have to be part of this eco-system and will have the most to gain as this evolves. Together, we can prove that food and not laughter, is the best medicine.