Milk is commonly enriched with nutrients such as vitamin D, vitamin A, iron, and folic acid. Photo Credit: Tima Miroshnichenko / pexels.com
Adding essential vitamins and minerals to widely consumed foods is one of the most practical and affordable ways to improve nutrition at a population level. These programs help address gaps in everyday diets, preventing serious deficiency-related conditions such as rickets and pellagra while enhancing overall health worldwide.
A recent study in The Lancet Global Health presents the first comprehensive global evaluation of the benefits and costs of food fortification. An international team of researchers found that existing large-scale programs prevent roughly 7 billion cases of micronutrient inadequacy each year, at an average cost of about $0.18 per person. Co-author Christopher Free, principal investigator with the Marine Science Institute and a research professor at UC Santa Barbara, emphasizes that expanding fortification efforts to more countries and additional staple foods could significantly increase this impact at relatively low cost.
Micronutrient deficiencies remain a widespread challenge, affecting billions of people and contributing to weakened immune systems, increased disease risk, and impaired cognitive development. The study estimates that improvements and expansion of current programs could prevent up to 25 billion cases of inadequate nutrient intake annually. This large figure reflects the fact that individuals may experience deficiencies in multiple micronutrients at the same time.
The research, led by the Global Alliance for Improved Nutrition (GAIN) with collaborators from the University of California, the World Bank, and Tufts University, analyzed fortification efforts across 185 countries, representing more than 99% of the global population. The team combined dietary intake data, household survey information, and global fortification records to model nutrient consumption and compare it with established nutritional requirements for 13 essential micronutrients.
The findings show that current programs avert about 7 billion cases of inadequate intake annually, with iodized salt accounting for nearly half of the total benefit. Iron fortification of flour and the enrichment of other staples such as rice, maize flour, and cooking oil also contribute significantly. Despite this progress, an estimated 38.6 billion cases of micronutrient inadequacy still occur each year, driven by limited program coverage, weak compliance with fortification standards, and poor diet quality in many regions.
The study identifies several ways to expand impact. Improving compliance with existing regulations to high levels could prevent an additional 6.1 billion cases annually at minimal added cost. Aligning national standards with World Health Organization recommendations, combined with stronger compliance, could prevent 10.3 billion more cases. Expanding programs to countries with the greatest need, alongside improved standards and adherence, could prevent up to 17.7 billion additional cases each year.
Our study shows that large-scale food fortification is a cost-effective intervention for preventing inadequate micronutrient intakes, and expanding food fortification to include more countries and foods could prevent billions more at low additional costs.
Globally, about 2.6 billion people cannot afford a healthy diet, according to the UN Food and Agriculture Organization. Fortification programs, particularly when subsidized, can help bridge this gap by improving nutrition, health outcomes, and economic productivity. Even under the most comprehensive scenario, the projected annual cost of $9.2 billion, or about $1.15 per person, remains modest compared with the far greater economic losses associated with micronutrient deficiencies.
The researchers also examined potential risks from excessive nutrient intake. While most nutrients pose minimal concern, careful monitoring is necessary for iodine and zinc to avoid adverse health effects, underscoring the importance of setting appropriate fortification standards based on population needs.
Even with optimized programs, food fortification alone cannot eliminate all nutrient gaps. The study estimates that 20.9 billion cases of inadequacy would still persist, highlighting the need for complementary strategies such as improving dietary diversity, providing targeted supplementation for vulnerable groups, and increasing access to affordable, nutritious foods.
Adapted from reporting by Harrison Tasoff, “Food fortification prevents 7 billion nutrient gaps annually — but could triple its impact,” The Current, UC Santa Barbara, 2026.