Food fortification: Adding micronutrients to prevent deficiencies worldwide
Food fortification: Billions benefit from added vitamins and minerals
Twelve-year-old Anjali sat in class, but her mind felt foggy. She couldn’t concentrate on the math problems in front of her. Her teacher’s voice seemed distant. Anjali felt constantly exhausted, struggled to remember lessons, and her grades were falling.
Her mother took her to a clinic in rural Maharashtra, India. Blood tests revealed severe anemia—Anjali’s iron levels were dangerously low. “This is very common,” the doctor explained. “Many children here have iron deficiency. Their diets lack enough iron-rich foods.”
The doctor prescribed iron supplements, but also explained something that would help prevent this in thousands of other children: the government’s new program to fortify wheat flour with iron, folic acid, and other essential vitamins and minerals.
Anjali’s story illustrates why food fortification has become one of the most powerful public health interventions worldwide. According to WHO’s work on food fortification, fortification is the practice of deliberately increasing the content of one or more micronutrients (vitamins and minerals) in a food or condiment to improve the nutritional quality of the food supply and provide a public health benefit with minimal risk to health.
For more on nutrition-related health topics, see our articles on malnutrition and healthy diets at ObserverVoice.com.
Understanding Food Fortification
Fortification is an evidence-informed intervention that contributes to the prevention, reduction and control of micronutrient deficiencies. It can be used to correct a demonstrated micronutrient deficiency in the general population (mass or large-scale fortification) or in specific population groups (targeted fortification) such as children, pregnant women and the beneficiaries of social protection programmes.
As well as increasing the nutritional content of staple foods, the addition of micronutrients can help to restore the micronutrient content lost during processing. WHO’s Q&A on food fortification provides essential information.
When the vitamins and minerals are not added to the foods during processing but just before consumption at home or at schools or child‐care facilities, it is called point-of-use fortification.
Dr. Francesco Branca, WHO’s Director of Nutrition and Food Safety, explained: “Fortification is invisible but powerful. People eat their regular foods—bread, rice, cooking oil, salt—without even knowing these foods now contain essential nutrients preventing serious deficiencies.” WHO’s podcast Episode #94 – Are you consuming too much salt? discusses balancing fortification with sodium reduction.
In addition to addressing micronutrient deficiencies, policies and implementation programmes for fortification need to consider alignment with policies for the reduction of diet-related noncommunicable diseases. Such is the case of salt iodization, which builds on sodium consumption and, as result, needs to consider strategies for sodium intake reduction. WHO published WHO global sodium benchmarks for different food categories, 2nd ed in April 2024 to address this challenge.
For more on related nutrition issues, see our articles on infant nutrition and dietary health at ObserverVoice.com.
WHO’s Recommendations
The World Health Organization recommends large scale food fortification as a powerful evidence-informed and cost-effective intervention to fight vitamin and mineral deficiencies, including iodine deficiency disorders, anaemia and iron deficiency.
Recommendations in all settings include universal salt iodization; and fortification of maize flour, corn meal, wheat flour and rice with vitamins and minerals.
WHO published Guideline: fortification of wheat flour with vitamins and minerals as a public health strategy in June 2022, providing clear, evidence-informed recommendations. Most recently, in October 2025, WHO released the WHO guideline on fortification of edible oils and fats with vitamins A and D for public health, with an official launch event held in November 2025.
For children living in different settings, WHO recommends micronutrient powders containing iron for point-of-use fortification of foods for infants and young children 6–23 months old or children 2–12 years. WHO published comprehensive guidance: Infant and young child feeding: model chapter for textbooks in September 2025. WHO’s fact sheet on infant and young child feeding provides additional information.
WHO’s e-Library of evidence for Nutrition Actions (eLENA) compiles all evidence-based nutrition interventions including fortification recommendations.
Mandatory vs. Voluntary Fortification
Mandatory food fortification occurs when governments legally oblige food producers to fortify particular foods or categories of foods with specified micronutrients, providing high certainty over time that they will contain a predetermined amount. Voluntary fortification occurs when a food manufacturer freely chooses to fortify particular foods in response to permission given in food law as a means to increase their brand value.
Globally, mandatory regulations are most often applied to the fortification of food with micronutrients such as iodine, iron, vitamin A and folic acid. Of these, the iodization of salt is the most widely implemented globally.
In May 2023, WHO announced a new WHA resolution to accelerate efforts on food micronutrient fortification, demonstrating global commitment to expanding fortification programs.
Dr. Maria Neira, who worked on fortification programs in Latin America, explained the difference: “Mandatory fortification ensures everyone benefits, regardless of income or education. Voluntary fortification reaches only those who can afford premium brands or have knowledge to choose them. For public health impact, mandatory programs are essential.”
For more on nutrition policy and healthy diets, see WHO resources and our articles at ObserverVoice.com.
Real-World Impact and Success Stories
WHO featured Peru’s efforts in tackling childhood anaemia in indigenous communities in May 2019, documenting how fortification programs combined with other interventions dramatically reduced childhood anemia.
WHO’s video Healthier diets through vitamins and minerals additions showcases successful fortification programs. Another video on Healthier diets through better nutritious options in schools and hospitals demonstrates implementation in institutional settings.
In September 2021, WHO announced monitoring flour fortification to maximize health benefits: a manual for millers, regulators, and programme managers, providing practical implementation tools.
Six months after Anjali started eating fortified wheat flour—now standard in her region—combined with her iron supplements, her transformation was remarkable. Her energy returned, her concentration improved, her grades rose. “I can think clearly now,” she said. “I can remember things. I feel like myself again.”
But Anjali represents just one child. Millions more benefit from fortification programs they don’t even know exist. WHO’s Global Database on the implementation of nutrition actions (GINA) tracks fortification programs worldwide.
Global Coordination and Technical Support
WHO has been working systematically in food fortification for decades and collaborates with different networks for fortification at regional, country and community levels.
WHO, the Food and Agriculture Organization of the United Nations and the Codex Alimentarius Commission developed general principles for the addition of essential nutrients to foods with the intention to provide guidance and protect health, while supporting implementation among Member States.
WHO’s Nutrition and Food Safety department coordinates global fortification work. Activities include developing nutrition guidelines, establishing global nutrient requirements, reducing population sodium/salt intake, and strengthening national food control systems.
WHO created the eCatalogue of indicators for micronutrient programs and maintains the WHO Micronutrients Database to track progress. The FAO/WHO Global Individual Food Consumption Data Tool (GIFT) provides consumption data essential for planning fortification programs.
In October 2020, WHO announced a new electronic survey manual to support countries in combating micronutrient deficiencies, providing tools for monitoring and evaluation.
WHO also monitors and reports progress on several nutrition targets affected by fortification such as the reduction of anaemia in women and the reduction of stunting in children under 5 years of age. WHO’s Q&A on what is malnutrition and fact sheet on malnutrition provide comprehensive context.
WHO’s video WHO’s department of nutrition and food safety: key achievements 2023 highlights recent progress including fortification initiatives.
Looking Forward: Climate Change and Fortification
At COP28 in December 2023, WHO convened a session on tackling micronutrient malnutrition in a warming world, exploring how climate change affects micronutrient availability in crops and the critical role of fortification.
In September 2022, WHO facilitated a meeting on using digital technologies in food fortification for improved nutrition outcomes, examining innovations in monitoring and implementation.
In September 2021, WHO participated in the UN Food Systems Summit, announcing new coalitions to increase access to healthy diets including fortification programs.
Multiple World Health Assembly resolutions guide this work, including WHA71.9 on infant and young child feeding, WHA69 on maternal, infant and young child nutrition, WHA68.19 on outcome of the Second International Conference on Nutrition, WHA60.21 on sustaining elimination of iodine deficiency disorders, WHA45.33 on national strategies for micronutrient malnutrition, and WHA37.18 on vitamin A deficiency.
The UN Decade of Action on Nutrition (2016-2025) provides the framework, with implementation reports to the UN General Assembly.
WHO’s Food Systems for Health initiative coordinates fortification within broader food system transformation. WHO’s commentary Malnutrition: It’s about more than hunger from October 2017 provides important context.
With WHO’s comprehensive approach to food fortification, millions of children like Anjali benefit from this invisible but powerful public health intervention—proving that sometimes the most effective solutions are the ones people never notice.
For more information, visit WHO’s food fortification health topic page or explore related content at ObserverVoice.com.
Frequently Asked Questions (FAQs)
According to WHO’s work on food fortification, fortification is the practice of deliberately increasing the content of one or more micronutrients (vitamins and minerals) in a food or condiment to improve the nutritional quality of the food supply and provide a public health benefit with minimal risk to health. As well as increasing the nutritional content of staple foods, the addition of micronutrients can help to restore the micronutrient content lost during processing. Fortification is an evidence-informed intervention that contributes to the prevention, reduction and control of micronutrient deficiencies. It can be used to correct a demonstrated micronutrient deficiency in the general population (mass or large-scale fortification) or in specific population groups (targeted fortification) such as children, pregnant women and the beneficiaries of social protection programmes. When vitamins and minerals are added just before consumption at home or at schools or child‐care facilities, it is called point-of-use fortification. WHO’s Q&A on food fortification and fact sheet on malnutrition provide comprehensive information. WHO’s Q&A on what is malnutrition explains the broader context. For more on nutrition and healthy diets, see WHO resources and our articles at ObserverVoice.com.
The World Health Organization recommends large scale food fortification as a powerful evidence-informed and cost-effective intervention to fight vitamin and mineral deficiencies, including iodine deficiency disorders, anaemia and iron deficiency. Recommendations in all settings include universal salt iodization; and fortification of maize flour, corn meal, wheat flour and rice with vitamins and minerals. For children, WHO recommends micronutrient powders containing iron for point-of-use fortification of foods for infants and young children 6–23 months old or children 2–12 years. WHO published Guideline: fortification of wheat flour with vitamins and minerals in June 2022 and WHO guideline on fortification of edible oils and fats with vitamins A and D in October 2025. WHO’s launch event for the oils and fats guideline was held November 2025. WHO published Infant and young child feeding: model chapter September 2025. WHO’s fact sheet on infant and young child feeding provides additional guidance. See our articles on child nutrition.
Mandatory food fortification occurs when governments legally oblige food producers to fortify particular foods or categories of foods with specified micronutrients, providing high certainty over time that they will contain a predetermined amount. Voluntary fortification occurs when a food manufacturer freely chooses to fortify particular foods in response to permission given in food law as a means to increase their brand value. Globally, mandatory regulatios are most often applied to the fortification of food with micronutrients such as iodine, iron, vitamin A and folic acid. Of these, the iodization of salt is the most widely implemented globally. In May 2023, WHO announced a new WHA resolution to accelerate efforts on food micronutrient fortification. Multiple resolutions guide this work including WHA71.9 on infant and young child feeding, WHA69 on maternal, infant and young child nutrition, WHA68.19 on Second International Conference on Nutrition, WHA60.21 on iodine deficiency disorders, WHA45.33 on micronutrient malnutrition, and WHA37.18 on vitamin A deficiency. See our articles on food policy.
WHO has been working systematically in food fortification for decades and collaborates with different networks for fortification at regional, country and community levels. WHO, FAO and Codex Alimentarius Commission developed general principles for the addition of essential nutrients to foods to provide guidance and protect health while supporting implementation. WHO’s Nutrition and Food Safety department coordinates work through activities including developing nutrition guidelines, establishing global nutrient requirements, reducing population sodium/salt intake, and strengthening national food control systems. WHO created the eCatalogue of indicators for micronutrient programs, maintains the WHO Micronutrients Database, provides the e-Library of evidence for Nutrition Actions (eLENA), maintains the Global Database on implementation of nutrition actions (GINA), and supports the FAO/WHO Global Individual Food Consumption Data Tool (GIFT). In September 2021, WHO announced monitoring flour fortification manual. In October 2020, WHO released electronic survey manual to combat micronutrient deficiencies. See our articles at ObserverVoice.com.
Fortification programs must adapt to emerging challenges including climate change impacts on micronutrient availability in crops. At COP28 December 2023, WHO convened tackling micronutrient malnutrition in a warming world. In September 2022, WHO facilitated using digital technologies in food fortification exploring innovations. WHO’s Food Systems for Health initiative coordinates fortification within broader food system transformation. In September 2021, WHO participated in UN Food Systems Summit announcing new coalitions. The UN Decade of Action on Nutrition (2016-2025) provides the framework with implementation reports and Secretary-General report. WHO published WHO global sodium benchmarks 2nd ed April 2024 balancing fortification with sodium reduction. WHO’s fact sheet on sodium reduction provides context. WHO featured tackling childhood anaemia in Peru and commentary Malnutrition: It’s about more than hunger. WHO’s video key achievements 2023 highlights progress. See our articles on climate and nutrition.
- WHO Food Fortification Health Topic
- WHO Q&A: Food Fortification
- WHO Q&A: What is Malnutrition?
- WHO Fact Sheet: Malnutrition
- WHO Fact Sheet: Healthy Diet
- WHO Fact Sheet: Sodium Reduction
- WHO Fact Sheet: Infant and Young Child Feeding
- WHO Guideline: Fortification of Edible Oils and Fats (Oct 2025)
Disclaimer: This article is an adaptation of publicly available information from WHO’s Food fortification
health topic page (WHO, Geneva. Licence: CC BYNC-SA 3.0 IGO). WHO is not responsible for the
content or accuracy of this adaptation. This content is for informational and educational purposes
only and does not constitute medical advice. ObserverVoice.com is a news and information platform
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