A major new study published in The Lancet Global Health revealed that large-scale food fortification currently prevents nearly 7 billion nutrient gaps every year. However, researchers say this is only the beginning. According to the report led by the Global Alliance for Improved Nutrition (GAIN), a strategic expansion of these programs could triple that impact, potentially closing 25 billion gaps in vitamin and mineral deficiencies worldwide.

“Our study shows that large-scale food fortification is a cost-effective intervention for preventing inadequate micronutrient intakes,” said co-lead author Christopher Free, research professor at UC Santa Barbara. “And expanding food fortification to include more countries and foods could prevent billions more at low additional costs.”

What is food fortification and why it matters

 Food fortification involves adding key micronutrients such as iron, iodine, vitamin A, and folic acid to commonly consumed foods like flour, rice, oil, and salt. These nutrients are critical for immunity, growth, and brain development, but many diets globally fall short.

Micronutrient deficiencies affect billions and are linked to poor health outcomes, lower productivity, and impaired cognitive development. Fortification helps battle these deficiencies because it does not require people to change what they eat, instead, it improves the nutritional value of foods at low cost. This makes it particularly valuable in low- and middle-income countries where access to diverse, nutrient-rich diets remains limited.

What the study found

The research, titled ‘Impact of large-scale food fortification programmes on micronutrient inadequacies and their implementation costs: a modelling analysis,‘ offers the first comprehensive global analysis of both the cost and impact of large-scale fortification programmes. The study was led by researchers at GAIN, in collaboration with the University of California, the World Bank, and Tufts University, and it modelled the impact of fortification across 185 countries, covering 99.3 per cent of the global population.

The study found that current programmes prevent around 7 billion nutrient gaps annually. This is achieved at a cost of just $0.18 (about ₹15-16) per person per year. Researchers highlight that iodised salt and iron-fortified flour account for a significant share of the current impact.

“Salt iodization alone prevents 3.3 billion iodine deficiencies each year—reducing global iodine deficiency by 87 per cent,” said Dr Mduduzi Mbuya, co-author of the study and Director of Knowledge Leadership at GAIN.

The study estimates that every dollar invested in fortification yields approximately $27 (around ₹2,500) in returns, driven by improved health outcomes and increased productivity.

Despite existing fortification efforts, an estimated 38.6 billion nutrient gaps persist globally, driven by poor diet quality, limited programme coverage, and weak compliance with fortification standards. These deficiencies affect 1 in 2 preschool-aged children and 2 in 3 women of reproductive age globally.

Even under a best-case scenario with optimised fortification programmes, an estimated 20.9 billion nutrient gaps would still persist, underscoring the need for complementary strategies.

“Fortification is a powerful tool, but it is most effective as part of a comprehensive strategy,” said Florencia Vasta, global lead for large-scale food fortification at GAIN.

“Achieving optimal nutrition for everyone will require parallel investments in dietary diversity, supplementation for vulnerable groups like pregnant women and young children and making healthy diets more affordable and accessible,” she adds.