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Food fortification has proven to be an effective approach for preventing micronutrient deficiencies in many settings. Factors that lead to successful fortification programs are well established. However, due to the multisectoral nature of fortification and the added complexities present in many settings, the barriers to success are not always evident and the strategies to address them are not always obvious. We developed a systematic process for identifying and addressing gaps in the implementation of a food fortification program. The framework is composed of 4 phases: (1) connect program theory of change to program implementation; (2) develop an implementation research agenda; (3) conduct implementation research; and (4) analyze findings and develop/disseminate recommendations for next steps. We detail steps in each phase to help guide teams through the process. To our knowledge, this is the first attempt to outline a systematic process for applying implementation science research to food fortification. The development of this framework is intended to promote implementation research in the field of food fortification, thus improving access to and effectiveness of this key public health intervention.
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http://dx.doi.org/10.9745/GHSP-D-20-00707 | DOI Listing |
Food Res Int
November 2025
Institute of Food Technology, Av. Brasil 2880, Jd. Chapadão, P.O. Box 139, Campinas, SP 13070-178, Brazil.
This study evaluated the feasibility of using ferrous sulfate microparticles (FSM), produced through the combination of spray drying and spray chilling techniques, to fortify plant-based yogurt and increase dietary iron intake. The stability of FSM was assessed, and iron bioavailability was estimated using the standardized INFOGEST in vitro digestion method, followed by Caco-2 cell culture assays. FSM showed moisture content and water activity (Aw <0.
View Article and Find Full Text PDFPLoS One
September 2025
Institute of Economic Growth, Delhi University Enclave (North Campus), Delhi, India.
Background: Although broad-scale data might suggest low prevalence, millions of children in India still suffer from Vitamin A and Vitamin D deficiencies despite India's existing guidelines for Vitamin A deficiency. To address the issue, the Government of India has recommended fortification of oil and milk to improve Vitamin A and Vitamin D consumption. However, there is limited information on the health benefits and cost-effectiveness of fortifying oil and milk at scale.
View Article and Find Full Text PDFEur J Nutr
September 2025
Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Background: The UK has a high and increasing prevalence of folate deficiency. The decision to start mandatory folic acid fortification has not yet been implemented. Concern has been raised about the effect of high folate on vitamin B12 status.
View Article and Find Full Text PDFCurr Dev Nutr
August 2025
School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire, United Kingdom.
Background: With near universal consumption of salt and technological advances that have made its fortification with multiple micronutrients feasible, salt has great potential for public health impact as a delivery vehicle for not only iodine but also multiple micronutrients. Decisions around modifying existing salt standards to include additional micronutrients should consider not only potential impacts but also stakeholder-specific costs.
Objectives: We aimed to estimate the total and incremental cost of expanding Ethiopia's salt iodization program to include folic acid (dual fortified salt), folic acid and vitamin B-12 (triple fortified salt), or folic acid, vitamin B-12, and zinc (quadruple fortified salt).
BMC Res Notes
September 2025
Wolfson Institute of Population Health, Barts and The London School of Medicine, Queen Mary University of London, 327 Mile End Rd, Bethnal Green, London, E1 4NS, UK.
Objective: To explore the perceptions and attitudes of vitamin D deficiency (VDD) and cultural influences in people from minority ethnic groups aged 60 + in East London through thematic analysis of qualitative semi-structured interviews.
Results: Nine participants were interviewed (7 in-person, 2 by phone). Participants were recruited by purposive and snowball sampling through East London organisations, local council authorities and website email contacts.