Micronutrient deficiency is one of the most common public health problems in developing countries. Vitamin and mineral deficiencies account for about 10 percent of the global health burden. In particular, mothers and children across Asia are not getting enough vitamin D -- a contributing source to child undernutrition in Asia, home to over 578 million malnourished children.

Improved health and nutrition are not just a matter of eating more foods with naturally occurring nutrients. For many people, there is a lack of availability of or cost of such foods. Food fortification is a complimentary strategy to improving micronutrient intake where tiny amounts of key vitamins and minerals are added to staple foods that people consume on a daily basis. In settings and geographic regions were a diversified diet is not feasible, food fortification -- while no magic bullet to end malnutrition -- helps to fill this important nutritional gap

From Rebecca Spohrer's article:

When I explain what food fortification means to friends outside of international development, their initial reaction is that adding essential micronutrients to basic, staple foods would be unnecessary if people just ate more natural foods like fruits, vegetables, and whole grains. This is too idealistic for two reasons:

1. Very low-income households, especially in developing countries, cannot afford to diversify their diets even if they know they should. Take Bangladesh for example, where rice alone constitutes 70-80% of diets. While the situation is gradually improving with economic development, it is a long process. Children born today have reduced potential in life due to micronutrient deficiencies. Nearly half of children under 5 in Bangladesh are stunted, which means they are short for their age and will be permanently underdeveloped due to malnutrition.

2. Secondly, in actuality it is virtually impossible to obtain enough of certain key micronutrients, like folic acid and iodine (with the exception of Japan where high quantities of iodine-rich seaweed is consumed), through natural foods, even in high-earning and educated populations. Women who plan to become pregnant need 400ug of folic acid daily. To obtain this naturally they would need to eat 44 ripe tomatoes, 14 cups of broccoli or four slices of fried beef liver every day. In areas far from salt water, such as the Midwest United States or the Swiss Alps, a local diet without iodised salt would not contain enough iodine needed for a healthy life. These micronutrients are critical before and during pregnancy. Consuming adequate folic acid helps reduce the risk of neural tube defects like spina bifida by up to 70%, and iodine deficiency is the world's single most preventable cause of brain damage at birth.

Now there is even more evidence pointing to the ongoing relevance of food fortification. A study published 27 January 2014 in the United States found that without fortification, the diets of a large number of American children and teens would be nutritionally inadequate. Fortified foods contributed half or more of the intakes of vitamin D, thiamin, and folate to diets; 20-47% of the intakes of vitamin A, vitamin C, B vitamins, and iron; and 12-18% of the intake of zinc.

Through food fortification anyone with access to basic staple foods like flour-based products, vegetable oil, and salt can benefit without changing their consumption habits. And everyone can be protected from folate and iodine deficiency, an unrealistic feat through diet alone.

Overall consuming more fortified foods is not a dietary recommendation: a diverse diet of fruits, vegetables, fish, meat and dairy can provide the best sources of essential vitamins and minerals. And we must continue to increase awareness, knowledge and access so consumers can make better food choices for their families. However, in the meantime, food fortification is helping fill critical nutritional gaps.

This article was originally posted on The Guardian: 44 Ripe Tomatoes: Why food fortification matters