Tackling malnutrition with fortification

Across the world, people are becoming more conscious of their own health than ever before. Governments and regulatory bodies are putting more and more pressure on manufacturers to deliver food and beverages that support a healthy lifestyle and there are ongoing campaigns to educate consumers about the importance of diet. In particular, the media offers a wealth of accessible information about health and nutrition and its use is constantly increasing. In South Africa, for example, 97 per cent of consumers regularly watch TV – averaging four hours of viewing time a day – and over 50 per cent consume digital media.  With such high levels of engagement, it is easy to see how people are learning more about topics such as value of balanced food choices.


Health is a multi-faceted issue, but one of its key pillars is micronutrient status. Ensuring the right intake of vitamins and minerals is crucial for physical and mental development in adults and children alike. Despite this, millions of people globally do not have enough essential micronutrients in their daily diet. Anemia, for example, is often the result of either a deficiency of iron or vitamin B12 and affects almost a quarter of the world’s population.  Other devastating examples include vitamin A deficiency, which is commonly behind preventable blindness in children, and iodine deficiency – the primary cause of preventable brain damage in children. There are a range of ways that people can increase their micronutrient intake, with a well-balanced diet being the most recommended method. However, where this is difficult to achieve or when extreme deficiencies of particular vitamins need to be addressed, eating foods with added vitamins and minerals or taking supplements are simple and effective solutions.

For a number of years, vitamins and minerals have been added to commonly consumed foods to improve their nutritional value. This process is known as fortification and it is a proven and well-recognised method of addressing micronutrient deficiencies, without requiring a change in a person’s daily diet. Some foods, such as flour and rice, can lose essential vitamins and minerals during the food production process. Fortification can replace these micronutrients or add new ones to boost the nutritional content. This is particularly effective in addressing the phenomenon known as ‘hidden hunger’ – where an individual is consuming enough calories but not enough vitamins and minerals, leading to malnourishment. Hidden hunger is particularly dangerous as an individual may not realise they are undernourished and, therefore, take no action. However, fortifying staple foods means that people do not need to adjust their behaviour, but their micronutrient intake is still increased.

Additionally, it is becoming more commonplace for foods to be fortified to appeal specifically to health-conscious consumers. By adding additional micronutrients to a food or beverage, brands can appeal to individuals actively searching for foods that support their lifestyle with specific health benefits. Similarly, supplementation, which is used to address deficiencies, is also a method of informed consumers use to supporting particular health concerns.

Understanding vitamins

In South Africa, the overall vitamins and supplements category has grown over the last two years, both in value and volume.  To better understand the awareness and perceptions of vitamins and minerals in South Africa, DSM recently undertook a research project in the region. It is hoped the results can to help develop initiatives that address micronutrient deficiencies, and support innovation within the industry.

The research found that 85 per cent of South African consumers know about vitamins and minerals, and over 90 per cent believe them to play a critical role in overall health and wellness. This wide understanding of the importance of micronutrients is certainly positive, however it should be noted that consumers in lower Living Standards Measure (LSM) groups with less education were found to have slightly less awareness. In many cases, it is the groups with the least disposable income that are most at risk of deficiencies, due to a lack of access to a nutritious diet. Improving the knowledge of these groups could therefore be crucial in improving their health.

The survey also identified that approximately three quarters of consumers in South Africa believe they get sufficient vitamins and minerals in their daily diets, with the internet-savvy the most confident about their intake. Aligning these beliefs with statistical data is vital to have a full understanding of the situation. For example, despite an overall sense of confidence about their health, nearly a third of children in the region are undernourished, while the majority of adults are overweight or obese.  Additionally, South Africa loses over USD1.1 billion in Gross Domestic Product each year due to vitamin and mineral deficiencies, and over a third of child deaths are due to undernutrition.    This indicates that the reality of nutrient intake in the region may be far bleaker than thought.

The future of fortification

As well as shedding light on knowledge and attitudes towards vitamins and minerals in general, the study also examined people’s opinions specifically on food fortification. Since 2003, the fortification of wheat and maize flour has been mandatory in South Africa – providing consumers with increased intake of a range of vitamins and minerals, including folic acid, iron and zinc. However, there is a range of other food and beverages that can be fortified, such as oil, milk and rice.

The survey revealed that the majority of people are aware of the fortification process and 84 per cent of consumers are more likely to purchase certain food products if additional vitamins and minerals have been added. Consumer acceptance is incredibly important to the success of any fortification initiative, so this figure supports the effectiveness of programs in the region. However, just over a quarter of consumers are not confident in identifying fortified foods.

The research also found that younger consumers, aged 15-24, are slightly less inclined to purchase fortified products. There are a range of reasons why this may be and, as this group’s purchasing power grows, understanding this rationale could be key for future fortification programs. Interestingly, those most likely to choose to buy fortified products are consumers that shop online, and those that regularly watch television.

Partnering for success

With micronutrient deficiencies one of the biggest threats to human health globally, it is essential that consumer attitudes are understood to ensure that fortification programs are successful across the globe. This requires collaboration across the entire supply chain. As a pioneer in food fortification, DSM, the world’s leading manufacturer of ingredients for health and nutrition, has been actively engaged in tackling vitamin and mineral deficiencies since such interventions began. With its expertise and experience in fortification, DSM has been the industry’s partner of choice for decades, providing the technical knowledge and high-quality micronutrients to address nutritional gaps without compromising on consumers’ taste or texture expectations.

AUTHOR: Monique Smorenburg, market development manager DSM Nutritional Products