Micronutrient fortification of foods — rationale, application and impact

Deficiencies in intake of essential vitamins and minerals (commonly referred to as micronutrients) that are essential for efficient energy metabolism and other functions of the human body (commonly termed as micronutrients) are severe and widespread in many parts of the world. They cause an immeasurable burden on individuals, on health services, education systems and families caring for children who are disabled or mentally impaired. Studies by World Bank have shown that countries whose populations suffer from micronutrient deficiencies encounter economic losses as high as 5% of gross domestic product (GDP). The solution to control and prevent micronutrient deficiencies is available and affordable. At a national level, micronutrient malnutrition can be addressed by implementing programmes designed to educate people to diversify their diets (where appropriate foods are available), or by fortifying commonly eaten foods with the missing micronutrients or providing nutrient supplements through targeted distribution programmes. Food fortification is increasingly recognized as an effective means of delivering micronutrients. Fortification of foods can provide meaningful amounts of the nutrient at normal consumption of the food vehicle. Proper choice of fortificant and processing methods could ensure the stability and bioavailability of the nutrient. The level of fortification should take into account variations in food consumption to ensure safety for those at the higher end of the scale and impact for those at the lower end. Fortification needs to be supported by adequate food regulations and labeling, quality assurance and monitoring to ensure compliance and desired impact. In industrialized countries food fortification has played a major role in the substantial reduction and elimination of a number of micronutrient deficiencies. Although a growing number of large scale fortification programmes in different parts of the world are beginning to demonstrate impact at the biochemical level and are leading to the elimination of several nutrient deficiencies, food fortification remains an underutilized opportunity in many developing countries where micronutrient malnutrition remains a public health problem.