Hundreds of millions still go to bed hungry every night. Many more suffer from micronutrient malnutrition or “hidden hunger,” experiencing deficiencies in key vitamins and minerals such as vitamin A, iodine, iron and folate.1 Most of these individuals live in low- and middle-income countries (LMIC), and they are often deficient in more than one vitamin or mineral. The groups most vulnerable to vitamin and mineral deficiencies include pregnant women, lactating women and young children.2,3 These deficiencies are associated with cognitive impairment, reduced immunity, and increased incidence and severity of infectious illness as well as associated mortality.4 The consequences of micronutrient malnutrition are not limited to health parameters alone but have far-reaching effects on economies through secondary physical and mental disabilities and reduced work productivity. Fortunately, part of the solution is the fortification of staples and condiments with essential vitamins and minerals. This intervention has gained global traction, and its health impact in LMIC is growing. Over 140 countries implement national salt iodization programs, 85 mandate at least one kind of cereal grain fortification, and over 40 mandate the fortification of edible oils and ghee.5 Important experience is now being accrued globally in reducing the prevalence of micronutrient deficiencies through fortification. Despite this, many fortification programs require targeted and aligned efforts by government, the private sector, academia, consumer groups, international agencies and donors to ensure effective and compliant coverage in order to achieve optimal and sustained impact.
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