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What does it take for India to realise its ambition of becoming a global leader? A thriving, healthy and productive population. Yet today, a silent crisis is undermining our progress: Micronutrient deficiencies, often called hidden hunger.
An estimated 76% of Indians do not consume the minimum required levels of essential vitamins and minerals such as iron, folic acid, vitamin A, vitamin B12, magnesium, and zinc. These invisible deficiencies impair cognitive development, increase maternal and infant mortality, weaken immunity, reduce learning ability, and lower productivity.
The impacts go beyond health. Malnutrition accounts for around 11% of India’s total disease burden. The economic cost is staggering, productivity losses due to iron deficiency alone may be costing us up to ₹35,000 crore each year.
If India is serious about building a $5 trillion economy and ensuring inclusive development, addressing this crisis must be a national priority. Food fortification enriching everyday staples with essential micronutrients, must be central to that effort.
Fortifying staples like wheat flour, rice, edible oil, milk, and salt is a globally proven, safe, and cost-effective solution. As of 2024, over 90 countries mandate wheat flour fortification, around 15 mandate rice, more than 30 fortify edible oil, about 40 fortify milk, and over 120 mandate iodised salt.
Fortification is unique; it enhances foods people already eat, without requiring any change in behaviour. India has started well and made notable progress. The nationwide rollout of fortified rice through food-based safety net programmes such as the Public Distribution System (PDS), mid-day meals, and anganwadi centres is among the world’s largest, backed by a ₹17,000 crore investment from the Government of India. Over nine crore beneficiaries are covered through PDS alone. Fortification of milk and oil with vitamins A and D is also underway, supported by clear FSSAI guidelines and the +F logo to help consumers identify fortified products.
Yet, most Indians still do not consume fortified foods. The open market, serving hundreds of millions, remains largely untouched. Wheat, a staple for over a third of the population, remains mostly unfortified even within government programmes, despite being technically simple and extremely cost-effective.
Even where fortification exists, there are gaps. Folic acid, vital for maternal and child health, is added at levels too low to meet daily needs. Other essential nutrients like zinc and magnesium, critical for immunity and growth, are missing from many fortification initiatives.
Concerns about overconsumption are sometimes raised. But this fear is not supported by evidence. Coverage of fortified foods in India remains low, and most people especially the poor, consume far less than the recommended daily intake of micronutrients. Fortification is designed to fill nutritional gaps, not cause excess. The risk of deficiency is far greater than the remote risk of overconsumption.
Nonetheless, as fortification scales, India must strengthen systems to monitor nutrient intake. Tools like clear labelling, dietary surveys, and risk-based checks will ensure safety and effectiveness. Quality control must also be robust and enforceable.
Consumer awareness remains low. Many people don’t understand what fortified foods are or how they help. Small and medium food producers often lack incentives, capacity or financial resources to implement fortification. Ironically, those most vulnerable to deficiencies are the least likely to benefit from current efforts.
Food fortification offers one of the highest returns on investment in public health estimated at ₹9 to ₹27 for every ₹1 spent. The cost is minimal: Less than 25 paise per person per day. It is a low-hanging fruit with high impact.
India has successfully tackled major public health challenges before from polio eradication to sanitation reforms through bold and coordinated action. We can do the same with micronutrient deficiencies, if we show the same ambition and resolve.
India’s current approach to food fortification is cautious. To bridge the gap between intent and impact, we need a bold national strategy. Fortification should be made mandatory for key staples in the open market. More nutrients like zinc and magnesium must be included. Strong monitoring systems with proper labelling, dietary surveys, and enforcement are essential. Food businesses should be encouraged through GST rebates, lower tax rates on fortified foods, and tax credits on inputs. And people need to know through a national campaign, why fortified foods matter.
Fortification alone is not enough. It cannot replace a healthy and balanced diet. But it is a practical and affordable tool, especially for those who lack access to diverse, nutrient-rich foods like fruits, vegetables, dairy, and pulses. For millions of Indians, it can help close critical nutrition gaps and build a healthier future.
India cannot afford to let hidden hunger erode its human capital. The science is clear. The tools are ready. The time to act is now.
Let us not treat nutrition as a footnote in our development story, let us make it a headline.
This article is authored by Pawan Agarwal, founder and CEO, Food Future Foundation and former CEO of FSSAI, and Tony Senanayake, CEO of Fortify Health (India).
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