Articles Vol. 67 No. 2 02/03/2026

OVERVIEW OF STUDIES ASSESSING THE ECONOMIC IMPACT OF MICRONUTRITIONAL FORTIFIERIZATION IN FOOD

Ong The Due1,2, Nguyen Thi Mai Phuong1,2, Dao Anh Son1,2
1 Department of Health Finance and Health Technology Evaluation, Institute of Health Strategy and Policy
2 Khoa Tài chính Y tế và Đánh giá công nghệ Y tế, Viện Chiến lược và Chính sách Y tế
DOI: 10.52163/yhc.v67i2.4384
19 Views
11 Downloads
Keywords
Economic impact, micronutrient fortification, iron, iodine, zinc, cost-effectiveness.
Abstract

Objective: Micronutrient deficiencies are a significant public health problem, causing substantial economic losses in many countries. Fortifying food with iron, iodine, and zinc is a widely recommended preventive measure, but policy implementation in some contexts remains challenging. This study aims to synthesize international evidence on the economic impact of the aforementioned three micronutrient fortification programs.

Methods: A desk study was conducted using data from two databases, PubMed and Google Scholar, to screen relevant studies and synthesize key findings.

Results: Evidence suggests that micronutrient fortification programs offer significant economic benefits. Iron fortification has a benefit-cost ratio ranging from 6:1 to 36:1 in different study contexts. The universal salt iodization program recorded a benefit-cost ratio of up to 30:1 and significantly reduced the burden of iodine deficiency disorders. Zinc fortification, particularly in countries with high wheat consumption, also showed positive effects with a benefit-cost ratio of approximately 14.6:1.

Conclusion: The combined evidence suggests that micronutrient fortification in food is a preventative health intervention with significant economic benefits. The results may support the review, adjustment, and improvement of policies to strengthen micronutrient fortification in Vietnam.

References
[1]
Bhutta Z.A et al. What works? Interventions for maternal and child undernutrition and survival. The lancet, 2008, 371 (9610): 417-440. Google Scholar
[2]
Detzel P, Wieser S. Food fortification for addressing iron deficiency in Filipino children: benefits and cost-effectiveness. Ann Nutr Metab, 2015, 66 (Suppl 2): 35-42. Google Scholar
[3]
Rob Baltussen, Cécile Knai et al. Iron fortification and iron supplementation are cost-effective interventions to reduce iron deficiency in four subregions of the world. The Journal of nutrition, 2004, 134 (10): 2678-2684. Google Scholar
[4]
Ma G et al. Iron and zinc deficiencies in China: what is a feasible and cost-effective strategy? Public Health Nutr, 2008, 11 (6): 632-8. Google Scholar
[5]
Prieto-Patron A et al. Reducing the burden of iron deficiency anemia in Cote D’Ivoire through fortification. J Health Popul Nutr, 2020, 39 (1): 1. Google Scholar
[6]
Wieser S et al. Burden of micronutrient deficiencies by socio-economic strata in children aged 6 months to 5 years in the Philippines. BMC Public Health, 2013, 13: 1167. Google Scholar
[7]
Garrett G et al. Doubling down on food fortification to fortify the future. Seattle, WA: Bill & Melinda Gates Foundation, 2019. Google Scholar
[8]
Horton S, Ross J. The economics of iron deficiency. Food Policy, 2003, 28 (1): 51-75. Google Scholar
[9]
Zimmermann M.B. Iodine deficiency. Endocrine reviews, 2009, 30 (4): 376-408. Google Scholar
[10]
Vitti P et al. Iodine deficiency disorders in Europe. Public Health Nutrition, 2001, 4 (2b): 529-535. Google Scholar
[11]
WHO, UNICEF, ICCIDD. Assessment of the Iodine Deficiency Disorders and monitoring their elimination, 2007: 1-98. Google Scholar
[12]
UNICEF. Global database on household iodized salt 2019. [cited 2024 December 12]. Available from: http://data.unicef.org/topic/nutrition/iodine-deficiency. Google Scholar
[13]
Schaffner M et al. The economic impact of prevention, monitoring and treatment strategies for iodine deficiency disorders in Germany. Endocr Connect, 2021, 10 (1): 1-12. Google Scholar
[14]
Gorstein J.L et al. Estimating the health and economic benefits of universal salt iodization programs to correct iodine deficiency disorders. Thyroid, 2020, 30 (12): 1802-1809. Google Scholar
[15]
Dold S et al. Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: a cross-sectional multicenter study. J Nutr, 2018, 148 (4): 587-598. Google Scholar
[16]
Adams K.P et al. Estimating the cost and cost-effectiveness of adding zinc to, and improving the performance of, Burkina Faso’s mandatory wheat flour fortification programme. Matern Child Nutr, 2023, 19 (3): e13515. Google Scholar
[17]
Bagriansky J et al. Implementing a revised standard for wheat flour fortification in Indonesia: A Benefit-Cost Analysis, 2023. Google Scholar