Food fortification is increasingly coming to light as one of the most cost-effective health interventions that exists today to address micronutrient malnutrition.
Find out what the New York Times, the Economist, and NPR have to say!
What is Food Fortification
Food fortification is the addition of key vitamin and minerals (e.g. iron, folic acid, iodine, vitamin A, and zinc) to staple foods to improve their nutritional content and address a nutritional gap in a population. A safe and effective means of improving public health that has been used around the world since the 1920s, it provides a nutritional benefit without requiring consumers to change eating habits or purchase patterns. In the developing world, commonly fortified foods include staple products such as salt, maize flour, wheat flour, sugar, vegetable oil, and rice.
Food fortification is also used in many developed countries. For those of you reading this who live in a developed country, yesterday you might have seasoned your food with iodized salt, enjoyed a glass of orange juice fortified with vitamin C, or poured milk that had vitamin D and calcium onto your cereal, which was fortified with iron, folic acid, and other B vitamins.
Food fortification is widely accepted by numerous populations and international and regional health organizations. It has proven incredibly successful in countries from the United States and Canada to Guatemala, Chile, South Africa, and China due to its proven cost effectiveness and health impact. The World Health Organization (WHO), UNICEF, and The Gates Foundation, to name only a few, endorse food fortification as a primary means of improving micronutrient health. In fact, the Copenhagen Consensus went so far as to determine that three of the top five most cost effective global development programs were micronutrient interventions.
What it Costs
The Copenhagen Consensus estimates that every $1 spent on fortification results in $9 in benefits to the economy. An initial investment is required to purchase both the equipment and the vitamin and mineral premix, but overall costs of fortification are extremely low. Even when all program costs are passed on to consumers, the price increase is approximately 1-2%, less than normal price variation.
Cost Versus Benefit
How do people obtain micronutrients?
Since most populations in resource-poor settings do not have access to adequate quantities of fruits, vegetables, and meats where micronutrients are abundant, and because providing vitamin tablets poses logistical and economic constraints, food fortification is a practical and inexpensive alternative.
However, for some particular population segments, fortification alone is not enough to provide adequate nutritional status since fortification only works when food is processed. There will always be people who grow and process their own food or buy non-processed staples (e.g. plantains, sweet potatoes) that fortification doesn’t reach. A number of different, complementary interventions are, therefore needed for these particularly groups to address vitamin and mineral deficiencies including supplementation, dietary diversification, education, and other public health measures.
Allen, de Benoist, Dary & Hurrell: Guidelines on food fortification with micronutrients, 2006. WHO, FAO.
Horton, Mannar & Wesley: Micronutrient Fortification, 2009. Copenhagen Consensus Center.
Investing in the Future: A United Call to Action on Vitamin and Mineral Deficiencies, 2009. FFI, GAIN, MI, USAID, World Bank, and UNICEF.