Executive summary

Micronutrients are essential vitamins and minerals that humans need in small amounts in order to develop and maintain good health and which are usually obtained through a balanced diet. Globally, more than two billion people suffer from deficiencies of micronutrients such as iron, iodine, folic acid and vitamin A. These deficiencies result in serious health and economic impacts, preventing ‘a third of the world’s population from reaching their physical and mental potential’.

The best medium- to long-term solution is to guarantee the right to food and nutrition by ensuring that all people have access to diverse, sustainable and healthy diets based on natural, traditional, nutritious foods. But balanced diets are not always accessible or affordable to all the vulnerable groups within a country’s population. Furthermore, it is difficult for many women to get the recommended daily amount of folic acid through their diet alone.

This report takes a closer look at a complementary solution: food fortification – the addition of micronutrients to food to correct or prevent deficiencies and improve public health. Adding essential vitamins and minerals to staple foods such as flour, oil and salt is a well-known, evidenced and costeffective strategy which is practised in many countries. Fortification of commonly consumed foods can be highly effective in tackling micronutrient deficiencies. So far, it has helped nearly eradicate disabilities associated with iodine deficiency and contributed to a significant reduction in deaths, disability and suffering associated with folic acid deficiency.

Food fortification can only work well through cooperation and partnership between the private sector, governments and civil society. It requires governments to put in place a robust legal framework that can regulate, monitor and enforce industry practices to ensure that public health is placed first. It is widely recognised that the food industry plays a crucial role in delivering this intervention that could save millions of lives. However, recent global research suggests that even where mandatory legislation exists in countries, less than half of products are adequately fortified to national standards. Furthermore, media reports highlight how some players in the food industry purposefully under-fortify foods to gain commercial advantage over their competitors.

In this report, we delve deeper into the issue of food fortification in Mexico, a country with a double burden of malnutrition. While it has one of the highest obesity rates in the world, certain micronutrient deficiencies, particularly iron deficiency, continue to be a public health concern. Mexico has attracted investment from the largest multinational food and beverage companies in the world. Some Mexican-owned food companies also have a significant global presence and therefore a big responsibility to play in providing nutritious foods and supporting healthy diets both within Mexico and worldwide. In addition, the Mexican government first mandated the fortification of wheat flour in 2000 and adopted legislation on the mandatory fortification of both wheat and maize flour in 2002. The current nutritional standards for the fortification of both flours have been in place for nearly a decade.

However, on the basis of publicly available information, this report highlights significant gaps with flour fortification in Mexico. Existing regulations omit crucial details about how the fortification standard should be externally monitored and enforced, seemingly leaving it up to the flour-milling industry to regulate itself. While the government seems to be doing some limited sampling and testing, it is not clear whether it also audits the fortification process at the flour mills. The available government sampling data show a variable level of compliance. While the levels of micronutrients in wheat flour seem relatively close to the requirements, the data show a significant drop in compliance in the fortification of maize flour with folic acid and omit analysis of other added micronutrients, such as iron and zinc. This casts doubt on the flour-milling and food-processing industries’ actions to provide Mexican people with sufficiently fortified flours, tortillas and breads to help tackle micronutrient deficiencies, in line with the legislation. The report therefore concludes with recommendations on how the situation could be improved, specifically with regard to strengthening the enforcement regime.