Poor nutrition is one of the biggest global challenges of our time. Today, hundreds of millions of people still suffer from micronutrient deficiency, otherwise known as “hidden hunger.” While hidden hunger rarely shows visible signs in those who are affected, its consequences can be disastrous, leading to poor physical and mental health, increased child and maternal mortality and reduced cognitive development.
Food fortification — adding small and safe amounts of micronutrients to staple foods and condiments — is a simple, scalable and highly cost-effective development intervention that is reaching billions across the world.
The example of flour fortification
The fortification of flour with multiple micronutrients (including zinc, iron and folate) can help to alleviate some of the most common micronutrient deficiencies of great public health and economic concern.
Food fortification is reaching billions across the world through its simplicity and scalability. In this guest column, GAIN's Greg S. Garrett writes how, possibly for the first time, all the major players in micronutrient fortification are aligned around a common set of issues that need to be addressed.
Zinc helps strengthen the immune systems and lessens complications from diarrhea, the number one killer of children under 5 in low- and middle-income countries (directly through dehydration and indirectly through preventing the absorption of essential macro and micronutrients). Iron and vitamin B complex (especially B12) prevent nutritional anemia, which improves productivity, maternal health and cognitive development. Folic acid reduces the risks of neural tube birth defects, a defect in the development of the spinal cord that can lead to lifelong physical and cognitive disability.
The private sector — especially millers and producers who fortify — are the gatekeepers to the nutritional health of the populations in their distribution network. It is therefore critical for the private sector to fully engage in the fortification process and to ensure that quality control and good manufacturing practices are in place. This will allow households to consistently have access to high quality, safe and adequately fortified foods.
Through developing large-scale food fortification programs, GAIN has proven that multi-stakeholder partnerships — when governments, civil society and business work together — are critical to success. These National Fortification Alliances enhance communication and collaboration, creating an enabling environment for support and advice on the process. Through these alliances, GAIN serves as a technical adviser to food industries, as well as a partner to governments to improve the quality and monitoring of fortified foods.
GAIN’s work to fortify staple foods and condiments with essential micronutrients reaches more than 1 billion people in 40 countries worldwide. GAIN-supported flour fortification programs have helped reduce neural tube defects in South Africa through flour fortification with folate and iron deficiency anaemia in Nigeria, Jordan and Morocco through flour fortification with iron.
Enforcement and compliance need to be strengthened to ensure the effectiveness of fortification programs and there is a strong need for the private sector to be the driving force for this change. Food fortification should be seen as an opportunity for industry to demonstrate corporate social responsibility and may at times provide industry a competitive edge.
For example, Urbano Rice — one of the leading rice millers in Brazil — noted compelling business opportunities in developing a fortified product, including competitive differentiation in a flat growth market; brand-building as an innovative and socially conscious company and expansion of the product line into export markets (Costa Rica and Peru, for example).
In 2010, Urbano launched a partnership project with the Global Alliance for Improved Nutrition and PATH to introduce affordable multiple micronutrient fortified rice in the Brazilian market, while raising awareness of the benefits of fortified products. Urbano consequently embraced fortification as part of its marketing strategy, co-investing substantially in store collateral, tasting booths, and other marketing materials to promote the product.
While food fortification is not the only solution — dietary diversity and affordable access to nutritious foods remain crucial in the fight against malnutrition — it is a powerful tool that enables children to perform better at school, prepares mothers for healthy pregnancies and prevents diseases that burden health care systems. As the world population grows and urbanizes, the role of industrially produced foods that can be fortified will continue to increase. The challenge now is to achieve adequate and safe fortification across the board, otherwise people will continue to be left behind.
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Corey Luthringer is a senior associate at the Global Alliance for Improved Nutrition. She has been a GAIN consultant on a variety of projects since 2014, working primarily within large-scale food fortification and issues of improving fortified food quality and regulatory monitoring. Since 2012, she has studied and consulted with various global health and nutrition organizations in Latin America, South Asia, Europe, and Africa, including BRAC in Bangladesh and the U.N. World Food Program in Italy and the regional bureau in Egypt, where she specialized in emergency nutrition and resilience building.
Beatrice Montesi is an external relations associate at the Global Alliance for Improved Nutrition. She currently oversees the implementation of the #FutureFortified campaign on social media to raise awareness for food fortification programs. Prior to joining GAIN, Beatrice worked at the U.N. World Food Program in Geneva, where she helped communicate the important humanitarian role played by the agency in emergency contexts. Beatrice is an international affairs specialist with a passion for food and nutrition security, women’s empowerment and global health.
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