Food fortification is a well-established public health intervention designed to address widespread micronutrient deficiencies in populations. Over time, this strategy has proven remarkably effective in tackling several serious health conditions. One of the most notable examples is the addition of iodine to salt, which successfully helped combat goitre, a painful swelling of the thyroid gland caused by iodine deficiency. Likewise, fortifying milk with vitamin D was pivotal in conquering rickets, a disease that weakens the bones of children.
Typically, the implementation of fortification programmes follows one of two models. These models are either mandatory or voluntary in nature. Under a mandatory framework, governments legally require certain food categories to be fortified with specific nutrients to remedy major public health concerns. The addition of iodine to salt, or the fortification of flour with folic acid or vitamin A to prevent neural tube defects are common examples of this model.
By contrast, the voluntary model of fortification presents a different approach. In this case, food manufacturers may choose to fortify their products as a way to enhance brand value. This practice is commonly seen in consumer goods such as breakfast cereals, beverages, and bouillon cubes, which are often fortified with iron and B vitamins.
In recent years, fortification has extended into the realm of ultra-processed foods (UPFs), a development that has generated considerable debate. Proponents argue that since people, particularly in developed countries, obtain a significant portion of their daily calories from UPFs, fortifying these products can help ensure that populations still receive some essential vitamins and minerals they might otherwise miss by not consuming enough healthy, natural foods.
However, this logic collapses when applied to developing contexts like Nigeria, where traditional and indigenous diets still dominate food tables. In such settings, fortifying UPFs can actually make things worse by accelerating a trend known as a nutrition transition, in which people gradually replace their healthy local meals with prepackaged and unhealthy options. This shift increases the population’s vulnerability to diet-related non-communicable diseases (NCDs) such as diabetes, hypertension, heart disease, and obesity.
Furthermore, the idea of adding a few micronutrients to an otherwise unhealthy ultra processed product to make it nutritious creates what scholars describe as a health halo effect. Consumers, misled by labels proclaiming “fortified with vitamins” may assume such foods are beneficial and consume them in excess, even though they often contain high amounts of sugar, salt, and harmful fats. This misconception contributes to the growing rates of hypertension, cardiovascular disease, and other chronic conditions, ultimately aggravating existing nutrition and public health issues rather than solving them.
More critically, fortifying UPFs is a band-aid solution that fails to address the underlying structural drivers of poor diets, especially those shaped by corporate food systems. It allows industry actors to profit from a public health crisis instead of confronting its root causes, which includes the limited access to affordable, wholesome foods. While fortified UPFs may contain added vitamins, they often lack other beneficial components found in whole foods, such as fibre, antioxidants, and a diverse range of naturally occurring micronutrients.
Additionally, widespread fortification of multiple food products can lead to the over-consumption of certain nutrients, especially if a person also takes dietary supplements. The excessive intake of vitamins and minerals such as vitamin A can have adverse health effects, including teratogenic risks during pregnancy.
In summary, while food fortification remains a valuable public health tool, its application to UPFs presents a paradox. It may offer limited benefits in contexts of severe deficiency but simultaneously deepens unhealthy consumption patterns and facilitates corporate capture of nutrition policy.
In Nigeria, where indigenous diets rich in natural micronutrients are not only culturally central but remain the most widely consumed sources of nourishment, promoting the fortification of UPFs could inadvertently legitimise junk food as public good. Instead of fortifying the problem, public health efforts should focus on protecting and expanding access to affordable, whole, and minimally processed foods that truly sustain life.
By Bukola Olukemi-Odele, food scientist and Project Officer (Cardiovascular Health, Food Policy Programme) at Corporate Accountability and Public Participation Africa (CAPPA)
