Why fortify flour and rice?

Countries add nutrients to flour and rice to help people and nations thrive. Iron, zinc, folic acid, and other B vitamins are commonly added to prevent anemia from nutritional deficiencies and reduce the risk of infants with severe brain and spine birth defects known as neural tube defects.

Fortification benefits individuals at every point in life - from conception to aging. Also, breastfeeding mothers, adolescents, and adults in their reproductive years need the nutrients included in fortified grains.

Nationally, fortification improves productivity and reduces healthcare expenditures. Globally, fortification addresses several of the Sustainable Development Goals and can restore nutrients lost in crops as a result of climate change.

A Matter of Life and Death

In 2016, an estimated 107,000 deaths were caused by iron deficiency anemia and other nutritional deficiencies. Pregnant women with severe anemia are twice as likely to die during or shortly after pregnancy than non-anemic women. About 75% of children with brain and spine birth defects die before their fifth birthday; many of these birth defects could be prevented with folic acid (vitamin B9).

Nutritional deficiencies also impact survivors. For example, iron deficiency in childhood stunts cognitive development which hinders academic performance and future earnings potential. Spina bifida, a spinal birth defect, has varying degrees of severity, and often leads to life-long disability.

FFI's Role

Fortification is successful primarily because it does not require consumers to change their behaviors. Governments and industries, however, need to make systematic changes to maximize fortification’s health benefits. FFI helps county leaders promote, plan, implement, and monitor sustainable grain fortification programs.

Vitamins and Minerals Added to Grains

Each country sets standards to include the specific nutrients its population needs.The following vitamins and minerals are used in flour and rice fortification globally:

  • Iron, riboflavin, folic acid, zinc, vitamin A, and vitamin B12 help prevent nutritional anemia which improves productivity, maternal health, and cognitive development.
  • Folic acid (vitamin B9) reduces the risk of severe brain and spine birth defects. Fortifying with folic acid may also have a role in the child's mental health.
  • Zinc helps children develop, strengthens immune systems, and lessens complications from diarrhea.
  • Niacin (vitamin B3) prevents the skin disease known as pellagra.
  • Riboflavin (vitamin B2) helps with metabolism of fats, carbohydrates, and proteins.
  • Thiamin (vitamin B1) prevents the nervous system disease called beriberi.
  • Vitamin B12 maintains functions of the brain and nervous system.
  • Vitamin D helps bodies absorb calcium which improves bone health.
  • Vitamin A helps individuals fight infections and helps prevent childhood blindness. It is often added to rice, cooking oils, margarine, or sugar instead of flour.
  • Calcium builds strong bones, helps transmit nerve messages and assists with muscle function and blood clotting. A few countries add calcium to flour, but it is more commonly added to other foods.
  • Selenium helps with reproduction and thyroid gland function.
  • Vitamin B6 is needed for enzyme reactions involved in metabolism.
  • Folic acid, vitamin B6 and vitamin B12 lower homocysteine levels.

Fortification as part of a country’s nutrition strategy is supported by global organizations such as UNICEF, the World Health Organization (WHO), the World Food Programme (WFP), the U.S. Centers for Disease Control and Prevention (CDC), the Global Alliance for Improved Nutrition (GAIN), and Nutrition International. For the latest evidence and guidance on nutrition interventions, see the WHO e-Library of Evidence for Nutrition Actions (eLENA).

For assistance, please contact us at info@ffinetwork.org. Also see how to donate to FFI's efforts to promote fortification of wheat flour, maize flour, and rice.

Top Photo Credit: @Flickr Creative Commons

These faces represent the main reasons to fortify wheat flour, maize flour, and rice.

For More Information:

  • Evidence for fortification of wheat flour with folic acid and vitamin B12. See more...

  • Summary of the benefits of fortifying with folic acid to prevent birth defects of the brain and spine, updated in July 2018. Also see the spreadsheet of documents reviewed.

  • Effectiveness of fortifying flour with iron to prevent iron deficiency. See more...

  • Food fortification and anemia. See more...

  • Summary of rice fortification's impact on nutrition. See a Sight and Life article and accompanying spreadsheet.

  • Flour Fortification With Iron, Folic Acid, Vitamin B12, Vitamin A, and Zinc: Proceedings of the Second Technical Workshop on Wheat Flour Fortification – Food and Nutrition Bulletin supplement – March 2010. See more...