An Assistant Director of Dietetics, Lagos State Health Service Commission, Mr Olusola Malomo, says fortification of ultra-processed foods remains a contested public health issue in Nigeria, requiring careful consideration.
Malomo, who spoke to the News Agency of Nigeria (NAN) on Sunday, said fortification of staples and widely consumed processed products could reduce inadequate micronutrient intake across low-income regions when properly implemented.
He said Nigeria’s reliance on such vehicles partly reflected limited access to diverse, nutrient-rich whole foods, with inflation and food insecurity restricting households’ ability to improve dietary quality.
“Fortification can reach people more effectively, but it should not be seen as a complete solution to micronutrient deficiencies”.
Malomo, however, acknowledged concerns raised by critics, including CAPPA and some public health researchers, over fortifying ultra-processed foods and its possible implications for unhealthy consumption patterns.
The dietitian who works at the Badagry General Hospital said fortification could create a “health halo”, making products high in salt, sugar and unhealthy fats appear healthy.
He added that it could also potentially encourage increased consumption of such food and worsen non-communicable disease outcomes.
According to him, fortified ultra-processed foods still lack fibre, antioxidants and the naturally occurring range of micronutrients found in whole foods, while excessive fortification could pose risks.
“Stacking fortification across many products risks over-consumption of some nutrients, including vitamin A, which carries teratogenic risk in pregnancy,” Malomo said.
The Assistant Director cited iron-fortified cassava, zinc-fortified maize and orange-fleshed sweet potato as alternatives, saying it could provide staple-level fortification without introducing additional sodium or cardiovascular risk.
Malomo said whether such fortification was appropriate remained a separate question, adding that Nigeria’s current debate centred largely on vehicle choice and dietary diversity.
On specific products, Malomo said the health implications varied considerably, noting that critics sometimes grouped different ultra-processed products in spite of their differences.
“Bouillon cubes are the current fortification discussed in the country, with the adoption of new standards for voluntarily fortifying bouillon with iron, zinc, folic acid and vitamin B12.
“Bouillon cubes are consumed by most households regardless of socioeconomic status or location, making them potentially effective vehicles for reaching populations requiring micronutrient interventions.
“Modelling using household consumption data indicated that bouillon fortification has the potential to virtually eliminate inadequacies of vitamin A, folate and vitamin B12.
“Bouillon is a condiment, eaten in small fixed amounts, not something anyone is going to over-consume the way they might a sugary drink”.
Explaining further, he said instant noodles, sugary drinks and packaged snacks presented a different situation because they are usually consumed in variable, often large quantities, requiring greater caution.
“These are foods people might eat in growing amounts precisely because they’re marketed as more acceptable, so the fortification can actively reinforce the wrong dietary shift”.
On whether fortification could make unhealthy products healthy, Malomo said it did not alter their overall nutritional profile, but only increased specified nutrient content.
“Fortifying a sugary breakfast cereal with iron and B vitamins gives you a product with more iron and B vitamins in it.
“It does not reduce the added sugar, fibre, or change the glycemic response,” Malomo said, adding that “fortified” and “healthy” answered different nutritional questions.
