Background

Fortification is key to eradicating ‘hidden hunger’

Published: 07/07/2020

There are two billion people in the world lacking sufficient micronutrients in their diet to support their body’s daily needs. The global ambition, under the UN’s Sustainable Development Goals (SDGs) is to eradicate malnutrition by 2030. With only a decade to reach their goal, we spoke to Yannick Foing, Global Director for Nutrition Improvement at DSM, on how the food industry is playing its part to eradicate malnutrition.

How bad is malnutrition globally?

According to the 2020 Global Nutrition Report, the burden of malnutrition, undernutrition and obesity is now the leading cause of death worldwide and this will be amplified by the current pandemic.

Today, some two billion people globally suffer from ‘hidden hunger’ – also known as malnutrition – where, despite getting enough calories, the diet lacks essential micronutrients, that is to say vitamins and minerals.

Micronutrient deficiencies are one of the main causes of poor health worldwide, so it is a significant issue and it is reported that an additional 300 million people will become micronutrient deficient by the end of the year.

Investing in nutrition delivers one of the highest returns in social development than any other area of development and food and drink companies have a crucial role to play

How are the UN Sustainable Development Goals (SDGs) tackling the problem (and are they making progress)?

At the heart of the SDGs is the ambition to achieve a world free of hunger and malnutrition. SDG 2 (zero hunger), SDG 3 (good health and wellbeing) and SDG 8 (decent work and economic growth) are central to achieving these aims. The value of partnerships (SDG 17) is also clearly recognized as having a key role to play in delivering against these goals.

Is progress being made? With regards malnutrition, after years of steady decline, the number of hungry people in the world has been increasing since 2015. The Covid-19 pandemic is expected to exacerbate these figures and potentially double the number of people severely malnourished, as a result of disruption of food supply chains, increased challenges in accessing healthy diets and loss of income as employment is impacted by disruptions to economic activity.

What role can the food and drink manufacturing industry play to solve this ‘hidden hunger’?

Investing in nutrition delivers one of the highest returns in social development than any other area of development and food and drink companies have a crucial role to play.

For example, one of the most effective and affordable solutions to address malnutrition, and which has been around for many years, is food fortification. By offering micronutrient-fortified foods and beverages, it is possible to reach vulnerable groups at risk of ‘hidden hunger’ with vital micronutrients.

Bringing rice fortification to scale could be a game changer for malnutrition

Vitamins have been safely added to essential foods such as bread, milk, cooking oil, cereals and spreads and as a result of food fortification, diseases such as goiter (iodine deficiency), scurvy (vitamin C deficiency), rickets (vitamin D deficiency), beri-beri (B1 deficiency) or pellagra (niacin deficiency), have been largely eradicated, and folic acid enrichment has drastically reduced the rate of babies born with neural tube defects.

However, we haven’t tapped the full potential of food fortification as many of the micronutrient-deficiencies and related health problems such as anemia and neural tube defects continue to persist worldwide.

What is meant by food fortification?

Food fortification can take several forms. It is possible to 1) fortify foods that are widely consumed by the general population (large-scale staple foods fortification), 2) to fortify foods designed for specific population subgroups for displaced populations (targeted fortification) and 3) food manufacturers can voluntarily fortify foods available in the market place (market-driven fortification).

Staple food fortification can have a life-long positive impact on a person’s livelihood and wellbeing, as well as achieving a huge social return on investment

Market-driven fortification can play a positive role in public health by contributing to meeting nutrient requirements and thereby reducing the risk of micronutrient deficiency. Food manufacturers can add specific amounts of one or more micronutrients to foods to fill the nutrient gaps of a population or specific groups without changing the taste of their products.

Voluntary and mandatory fortified foods have been shown to substantially contribute to help filling the micronutrient gaps of the diet.

How important is it to build (public/private) partnerships to achieving success?

No single organisation can eliminate hidden hunger alone. But through broad, multistakeholder partnerships that combine the private and public sectors, we can do it.

Companies can bring scientific and technical expertise, innovation and develop products that are nutritious, tasty, and affordable. They do need to collaborate with governments, communities, donors, and NGOs to ensure that these products meet the needs of the consumers and beneficiaries (such as nutritional deficiencies, dietary habits and taste), and reach them in a sustainable way. Accessibility, affordability and appeal of these products are key to ensure they will help support improving public health.

There is also a need to work together to increase the understanding of the importance of nutrition through public awareness and education programs to ensure acceptance of these nutritional solutions and products. Without acceptance, interventions may fail.

Can you give an example of a successful public-private partnership?

To effectively tackle the issue of micronutrient deficiencies, DSM — together with its partners at the World Food Programme, UNICEF, World Vision, Vitamin Angels, Africa Improved Foods, and the Sight and Life Foundation — has helped put hidden hunger high on the international development agenda.

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Through its partnerships with Sight and Life and Vitamin Angels, DSM is already working to implement Multiple Micronutrient Supplement interventions globally for pregnant women. Another partnership that DSM is involved with — the Healthy Mothers, Healthy Babies Accelerator, which is hosted by the Bill & Melinda Gates Foundation and led by the Micronutrient Forum — is working to end hunger, eliminate malnutrition, and drive women’s empowerment.

Finally, in January 2017, DSM joined 24 leading companies to launch FReSH – the Food Reform for Sustainability and Health program. Under the leadership of the World Business Council for Sustainable Development (WBCSD) and the EAT Foundation, FReSH aims to accelerate transformational change in global food systems and ensure the availability of healthy, affordable and enjoyable diets, that are responsibly produced. Only together can we tackle and eradicate hidden hunger.

Can you tell us more about how and why you fortify foods?

The best way to prevent micronutrient malnutrition is to ensure consumption of a balanced diet. Yet, the reality is that this is often not happening, and can be very challenging to realise, especially when a balanced diet is not affordable or accessible to vulnerable groups or the dietary habits are not in place.

The best way to prevent micronutrient malnutrition is to ensure consumption of a balanced diet

This is why the Lancet series on maternal and child undernutrition, the Copenhagen Consensus, and the Scaling Up Nutrition movement all consider tackling micronutrient deficiencies by implementing sustainable food fortification interventions and bundled micronutrient provisions as among the most cost-effective interventions with demonstrated impact. On a weighted average basis, every $1 invested in fortification generates $27 in economic return from averted disease, improved earnings, and enhanced work productivity.

Fortification of staple foods is a proven and cost-effective intervention to increase vitamin and mineral intake among general populations without impacting taste. It involves the addition of micronutrients to staple foods post-harvest to restore micronutrients lost during processing, for example milling, and food preparation — in addition to increase, with the aim of increasing the levels of specific vitamins and minerals lacking in the general diet to improve public health.

Fortification of staple foods is a proven and cost-effective intervention to increase vitamin and mineral intake among general populations without impacting taste

Staple food fortification has the potential to significantly improve health and reduce healthcare costs by millions each year. With the general health of the population improving, fortification also offers a wide range of economic benefits, including increased numbers of individuals in employment, and reduced instances of chronic illness in children, leading to improved performance in school. This can have a life-long positive impact on a person’s livelihood and wellbeing, as well as achieving a huge social return on investment.

What more can be done?

There is now great momentum for fortified rice to contribute to improving nutrition. Rice, as the number one staple in the world, offers indeed a promising vehicle to contribute to filling the nutrient gap. Rice is affordable and culturally engrained. More than 3 billion people across the globe rely on rice as a staple food, many of which live in developing countries where rice contributes as much as 75% of daily energy intake. Now more than ever, when consumers favour staple food for budgetary reasons, ensuring they are fortified is even more important.

The most robust technology to make rice nutritious in a sustainable and cost-effective way, is extrusion technology. DSM co-developed hot extrusion technology to produce fortified rice, and it is now globally the most used method to make fortified rice and a cost-effective method to improve micronutrient intakes. Bringing rice fortification to scale could be a game changer for malnutrition.

By Sara Lamonaca

Director, Consumer Information, Nutrition & Health

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