Fortified food — a big challenge ahead

Access to diverse and nutritious food, especially for low-income and marginalized populations, continues to be a major challenge in Pakistan. Even middle-class families are often devoid of a proper food basket for their growing children.

In Pakistan, where about 45 percent of the people, according to the World Bank, live below the poverty line, micronutrient deficiencies remain a very serious public health concern.

According to dietitians, human body needs mandatory fortification of essential nutrients to address its widespread deficiencies.

The World Health Organization also emphasizes, including fortified foods into consumer diets. A recent Gallup survey reveals an increase in medication supplementation from 20 percent in 2018 to 27 percent by 2025, which significantly affects healthcare costs, particularly medication expenses related to treating physical and mental illnesses.

Micronutrient deficiencies usually cause night blindness, fatigue, anaemia, goitre (thyroid) and other conditions that stymie strong immune functioning and simultaneous cell growth. Inadequate intake of essential vitamins and minerals by the vulnerable populations even leads to increased morbidity.

The National Nutrition Survey (NNS), conducted in 2018, shows that over 37 percent of households are food insecure, with only 14 percent of children receiving a meal with minimum dietary diversity, and 40 percent of children under 05 experience stunted growth.

The survey also highlights widespread micronutrient deficiencies, with 26.5 percent of women being hypocalcaemic, 27 percent of the population lacking sufficient vitamin A, and approximately 41 percent of women suffering from anaemia or iron deficiency. Other findings highlighted in the NNS underscore the pressing need for heightened awareness and advocacy efforts to address the nation’s nutritional challenges. As regards, the government must be asked if there is any monitoring and evaluation system in place to track progress on nutrition related goals, and how often such assessments are conducted?

Pakistan has introduced effective fortification practices that face significant challenges, particularly concerning local production entities such as small flour mills (chaki), local oil expellers (kohlus), and small-scale pink salt crushing plants. These producers often operate outside the regulatory purview of Pakistan Standards and Quality Control Authority (PSQCA), leading to inconsistencies in product quality and fortification levels.

Under the Pakistan Standards and Quality Control Authority Act, specifications are issued for the mass fortification of staple foods, including wheat flour, edible oil, ghee, and salt. However, the gap still exists in the adoption of a uniform fortification standard across all provinces of Pakistan. There is a dire need to understand the barriers faced by Small and Medium Enterprises or small-scale producers in adopting standards.

Businesses often prioritize profitability, and without adequate economic incentives or regulatory frameworks supporting fortification. Many companies may choose to abstain from these initiatives, limiting the availability of vital fortified products in the market. The lack of enforcement of fortification laws, as observed in Pakistan, has further reduced participation rates among companies. Moreover, the industry faces operational challenges in incorporating fortification into the existing workflow while maintaining cost efficiency during production.

Another limitation is the additional costs of fortification that can potentially raise consumer prices, which discourages companies from participating in such initiatives. To overcome these barriers, government intervention such as subsidies or tax compensation could provide the necessary incentives to encourage broader industry participation and ensure the widespread availability of fortified foods.

Provincial food authorities in the country have adopted standardized checklists as a crucial tool for data collection and to monitor regulatory compliance. These checklists provide a systematic framework for routine inspections, assessing compliance with nutrient fortification levels, monitoring labelling accuracy, and documenting instances of non-compliance.

Today, digitization through mobile applications and portal development can serve as a vital tool for creating and implementing standardized checklists for inspections across various localities, offering an auditable record that supports accountability and continuous program improvement. Furthermore, the data can be analyzed to develop an interactive dashboard, greatly aiding in evaluating the nutritional status across Pakistan. Can the use of digital tools be leveraged to educate consumers and encourage behavioural change?

To ensure compliance with fortification standards, the National Fortification Alliance (NFA) committee and NGOs must focus on consumer behaviour towards food fortification. It is influenced by multiple factors, including awareness, perceived value, sensory attributes, and socioeconomic conditions, all of which significantly impact decision-making in a complex marketplace.

Furthermore, processed foods available in the market should be made from fortified products, as consumer choices are influenced by regulatory and marketing factors such as products labelled as fortified or enriched.

Positive testimonials and health claims greatly influence decisions, as consumers often look to trusted sources for validation before making dietary changes. Therefore, evidence-based marketing strategies that deliver honest and transparent information can greatly improve consumer acceptance and support the successful adoption of fortified foods.

To conclude, food fortification can be a vital public health strategy to address common micronutrient deficiencies; therefore, expanding its implementation across the country is crucial. By incorporating essential nutrients into commonly consumed staples, fortification provides an effective way to deliver nutrients without altering dietary habits.

Fortified wheat flour with iron, folic acid, vitamin B12, Zinc, cooking oil with vitamins A and D, and table salt with iodine are expected to boost micronutrient uptake across the population, helping to prevent deficiency-related health issues. Hence, strengthening the monitoring and regulatory systems is essential to ensure that fortification processes consistently meet the required quality standards.

Copyright Business Recorder, 2025