ReviewFood and nutrition bulletin2018
Large-Scale Food Fortification and Biofortification in Low- and Middle-Income Countries: A Review of Programs, Trends, Challenges, and Evidence Gaps.
Review in Food and nutrition bulletin, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
97 citing papers in PubMed, 6 syntheses or guidelines pooled it, 214 citations in OpenAlex.
- Impact of nutrition-sensitive agricultural interventions on dietary diversity and selected nutritional outcomes among vulnerable populations in Ethiopia: a systematic review.BMC nutrition · 2026Pooled it
- Global folate deficiency among adolescent girls: A systematic review and meta-analysis.PloS one · 2026Pooled it
- The role of policy on fortification in food processing and value addition in Malawi and Mozambique-a systematic review.Frontiers in nutrition · 2026Pooled it
- Fortification of salt with iron and iodine versus fortification of salt with iodine alone for improving iron and iodine status.The Cochrane database of systematic reviews · 2022Pooled it
- Effect of Calcium Fortified Foods on Health Outcomes: A Systematic Review and Meta-Analysis.Nutrients · 2021Pooled it
- Improved micronutrient status and health outcomes in low- and middle-income countries following large-scale fortification: evidence from a systematic review and meta-analysis.The American journal of clinical nutrition · 2019Pooled it
- Determination of Folate Bioavailability From Brewer's Yeast in a Dual Isotope Randomized Human Intervention Study.Molecular nutrition & food research · 2026Trial
- Community Perceptions of Zinc Biofortified Flour during an Intervention Study in Pakistan.Nutrients · 2022Trial
- High Bioavailability from Ferric Pyrophosphate-Fortified Bouillon Cubes in Meals is Not Increased by Sodium Pyrophosphate: a Stable Iron Isotope Study in Young Nigerian Women.The Journal of nutrition · 2019Trial
- Contribution of commercial infant products and fortified staple foods to nutrient intake at ages 6, 12, and 18 months in a cohort of children from a low socio-economic community in South Africa.Maternal & child nutrition · 2019Trial
- Interface of Climate and Environmental Change on Food Systems-A Report from the "Agriculture and Diet: Value Added for Nutrition, Translation, and Adaptation in a Global Ecology" (ADVANTAGE) Project Working Group 3.Advances in nutrition (Bethesda, Md.) · 2026Review
- Article
- Diversified food fortification portfolios can enhance coverage of micronutrient-vulnerable populations in West Africa.Nature food · 2026Article
- [Review and comment "Guidance for salt fortification with iodine: a renewed commitment to achieve optimal iodine nutrition"].Problemy endokrinologii · 2026Review
- Folate-Containing Fermented Foods of Plant and Animal Origin: The Value of Traditional Foods to Tackle Folate Deficiency.Food science & nutrition · 2026Review
- Impact of large-scale food fortification programmes on micronutrient inadequacies and their implementation costs: a modelling analysis.The Lancet. Global health · 2026Article
- Seasonal Food Availability, Preservation Practices, and Dietary Diversity in Children Under 5 in Western Kenya.Public health challenges · 2026Article
- Matrix-controlled iron bioavailability in unrefined whole-pulse low-moisture extrudates.Current research in food science · 2026Article
- Impacts of large-scale food fortification on the cost of nutrient-adequate diets: a modelling study in 89 countries.BMJ public health · 2026Article
- Large Scale Food Fortification (LSFF) in East, Central, and Southern Africa: Gaps, opportunities and the way forward.PloS one · 2026Article
37 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFood fortification and biofortification are well-established strategies to address micronutrient deficiencies in vulnerable populations. However, the effectiveness of fortification programs is not only determined by the biological efficacy of the fortified foods but also by effective and sustainable implementation, which requires continual monitoring, quality assurance and control, and corrective measures to ensure high compliance.
objectiveTo provide an overview of efficacy, effectiveness, economics of food fortification and biofortification, and status of and challenges faced by large-scale food fortification programs in low- and middle-income countries (LMIC).
methodsA literature review of PubMed publications in English from 2000 to 2017, as well as gray literature, targeting nongovernmental organizations whose work focuses on this topic, complemented by national reports and a "snowball" process of citation searching. The article describes remaining technical challenges, barriers, and evidence gap and prioritizes recommendations and next steps to further accelerate progress and potential of impact.
resultsThe review identifies and highlights essential components of successful programs. It also points out issues that determine poor program performance, including lack of adequate monitoring and enforcement and poor compliance with standards by industry.
conclusionsIn the last 17 years, large-scale food fortification initiatives have been reaching increasingly larger segments of populations in LMIC. Large-scale food fortification and biofortification should be part of other nutrition-specific and nutrition-sensitive efforts to prevent and control micronutrient deficiencies. There are remaining technical and food system challenges, especially in relation to improving coverage and quality of delivery and measuring progress of national programs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.