Jointly reviewed by:

Introduction

Malnutrition remains a significant public health concern in Nepal, with a high prevalence of micronutrient deficiencies contributing to poor health outcomes (Shrestha & Bhattarai, 2023). Recent findings indicate that Nepal is experiencing a dual challenge of malnutrition. For instance, according to the recent Nepal Demographic and Health Survey Report, one in four children under age 5 are stunted, 8 percent wasted, and 19 percent underweight. (NDHS, 2022)

Food Fortification is the practice of deliberately increasing the content of one or more micronutrients (i.e., vitamins and minerals) in a food or condiment to enhance its nutritional value and contribute to public health benefits with minimal health risks. In addition to enriching staple foods with essential nutrients, fortification can also help replenish the micronutrient levels lost during food processing. In recent years, innovations in food fortification have emerged as a promising strategy to address nutritional gaps and improve the overall health and well-being of the population. This article explores the innovations in food fortification and their potential impact on improving nutrition in Nepal.

Food fortification stands as a guiding principle in the arena of public health, providing a practical and effective means to address malnutrition and enhance the nutritional status of populations. Within Nepal, where micronutrient deficiencies are prevalent, fortifying staple foods such as salt, edible oil, wheat flour, and rice has emerged as a cornerstone strategy to bridge nutritional gaps and elevate the overall well-being of the populace. By enriching commonly consumed foods with essential vitamins and minerals, Nepal has made significant strides in augmenting the intake of micronutrients and improving health outcomes (Shrestha & Bhattarai, 2023).”

Looking beyond its borders, Nepal can draw inspiration from successful food fortification programs in other countries. For instance, Kenya has implemented large-scale fortification of maize flour with iron, zinc, folic acid, vitamin B12, and vitamin A since 2012, reaching over 80% of the population. This program has been supported by strong political commitment, stakeholder engagement, quality control, and monitoring systems, resulting in significant improvements in the micronutrient intake and status of women and children (World Food Programme, 2023).

Similarly, Costa Rica has mandated the fortification of rice since 1982, covering almost 100% of the population, which has contributed to the reduction of anemia, neural tube defects, and other micronutrient deficiencies (Fiedler et al., 2023).

Additionally, India has encouraged the voluntary fortification of milk and other dairy products since 2017, reaching over 30% of the population. This program, driven by the private sector with government support, has leveraged existing infrastructure and consumer demand for dairy products, resulting in positive impacts on vitamin A and D intake (Food Safety and Standards Authority of India, 2023).

Food fortification programs around the world have been successful in addressing nutrient deficiencies and improving public health outcomes. Nepal can draw inspiration from these success stories and enhance its own fortification efforts by increasing potential food vehicles and embracing innovative strategies.

Innovative Technologies

Bio fortification: One such strategy is bio fortification, which involves increasing the micronutrient content of crops through conventional breeding or genetic engineering. This approach offers a sustainable solution to nutrient deficiencies by developing crop varieties with naturally higher levels of essential nutrients. For example, bio fortified crops like orange-fleshed sweet potatoes, iron-rich beans, and zinc-rich rice have been developed to provide higher levels of key nutrients such as vitamin A, iron, and zinc. By integrating bio fortified crops into agricultural practices, Nepal can improve the nutritional quality of staple foods and enhance the health outcomes of its population (Bhattarai et al., 2023).

Nanotechnology: Nanotechnology plays a crucial role in improving the delivery, stability, and bioavailability of micronutrients in fortified foods. Nanoparticles, which are particles with dimensions on the nanometer scale, can encapsulate micronutrients such as iron, zinc, and vitamin A, protecting them from degradation and enhancing their absorption in the body. Nano encapsulation allows for precise control over nutrient release, ensuring optimal delivery and utilization. By incorporating nanotechnology into food fortification processes, Nepal can develop fortified foods with enhanced nutritional properties and improved health benefits (Singh et al., 2023).

Microencapsulation: Another innovative strategy is microencapsulation, which involves coating micronutrients with a thin layer of food-grade material to form small particles called microcapsules. This technique protects the micronutrients from environmental factors such as heat, light, and oxygen, and prevents undesirable interactions with other food components. Microencapsulation also improves the sensory characteristics of fortified foods, such as taste, color, and odor, by masking the flavor and appearance of the micronutrients. By applying microencapsulation to food fortification, Nepal can produce fortified foods with improved stability, quality, and acceptability (Gouin, 2023).

Extrusion: Extrusion technology offers a versatile method for producing fortified foods with desirable textures and nutritional profiles. During the extrusion process, a mixture of ingredients is forced through a die under high pressure and temperature, resulting in the formation of food products with uniform shapes and textures. Extrusion can be used to incorporate essential nutrients into a wide range of food products, including ready-to-eat snacks, cereals, and pasta. Fortified extruded foods are shelf-stable, convenient, and nutritious, making them suitable for addressing nutrient deficiencies in diverse populations. By leveraging extrusion technology, Nepal can diversify its range of fortified foods and increase their accessibility to the population.

Digital Technologies: Digital technologies play a crucial role in strengthening food fortification programs through data-driven approaches. These technologies encompass electronic devices and systems used to collect, store, process, and communicate information related to food fortification initiatives. Digital tools enable real-time monitoring of production processes, distribution channels, and consumer behavior, facilitating data-driven decision-making and program optimization. Furthermore, digital platforms can be utilized to raise awareness about fortified foods, educate consumers on their nutritional benefits, and promote adherence to fortification guidelines. By harnessing the power of digital technologies, Nepal can enhance the efficiency, effectiveness, and sustainability of its food fortification programs, ultimately improving the nutritional status and health outcomes of its population.

Impacts on Public Health:

The potential impact of food fortification extends beyond merely improving nutrient intake. It has the potential to significantly impact various aspects of public health and well-being. By addressing nutrient deficiencies, food fortification can lead to reduced morbidity and mortality rates, improved cognitive development, and enhanced immune function among populations. Furthermore, fortified foods have the potential to reach a broad segment of the population, including vulnerable groups such as pregnant women, children, and marginalized communities, who are often at higher risk of malnutrition. This inclusive approach ensures that the benefits of fortification are accessible to those who need them the most, thereby promoting equity and social justice in nutrition interventions.

Moreover, food fortification is recognized as a cost-effective public health intervention. By reducing the prevalence of micronutrient deficiencies and associated health conditions, fortification programs can generate significant economic benefits. These include savings in healthcare costs related to the treatment of micronutrient deficiency disorders, as well as increased productivity and economic growth resulting from improved health outcomes. Thus, fortification not only improves individual health but also contributes to the overall socioeconomic development of communities and nations.

Conclusion: In conclusion, food fortification stands as a beacon of hope in the realm of public health, offering a practical and impactful solution to combat malnutrition and improve the nutritional status of populations. Nepal’s journey towards fortifying staple foods exemplifies a proactive approach to addressing widespread nutrient deficiencies and promoting better health outcomes. By learning from successful experiences globally and embracing innovative strategies, Nepal can pave the way for a healthier future for its people.