Multifortified Foods at Scale: Bridging Product Innovation, Health Impact, and Delivery Systems for Low- and Middle-Income Countries

Micronutrient malnutrition remains a critical global challenge, affecting over two billion people and impeding physical health, cognitive potential, and economic development. Food fortification has long been championed as a scalable and cost-effective intervention to combat these deficiencies, particularly in low- and middle-income countries (LMICs). However, the progression from single-nutrient fortification to multifortified foods, those enriched with multiple micronutrients introduces complex scientific, technological, and regulatory hurdles. Emerging studies underscore the potential of multifortified products to simultaneously address overlapping deficiencies, yet questions persist around bioavailability, matrix interactions, stability, and consumer sensory acceptance. Equally, implementation pathways are shaped by diverse market structures, regulatory standards, and governance frameworks that determine how innovations reach consumers. While promising advances have been made, the field lacks integrative models that connect innovation in formulation with real-world delivery and measurable health impacts, highlighting the enabling role of coherent standards and sustained regulatory mechanisms in successful implementation. This underscores the need for cross-disciplinary collaboration spanning food science, nutrition, health evaluation, policy, and industry practice.This Research Topic aims to establish a comprehensive platform that bridges innovation and implementation in multifortified foods, fostering systems-level understanding from product design to population nutrition outcomes. It seeks to unify evidence across scientific, regulatory, and commercial domains to identify the enablers and barriers of large-scale adoption in LMIC contexts. Central objectives include understanding how multifortification strategies can achieve nutritional effectiveness while maintaining sensory quality and affordability, evaluating scalable delivery platforms, and examining how robust policy frameworks, technical standards, and industry incentives collectively act as enablers of long-term impact. In doing so, the Topic addresses critical questions about translating technical feasibility into measurable health and economic gains, supporting global ambitions for improved micronutrient adequacy.This Research Topic focuses on the interface between innovation and implementation for multifortified foods, with a geographical focus on LMICs and a thematic emphasis on the full innovation–to–impact pathway. To gather further insights across this field, we welcome articles addressing, but not limited to, the following themes:1. Food design and formulation challenges: Stability and bioavailability of multiple micronutrients; nutrient–nutrient and nutrient–matrix interactions; understanding of processing effects (thermal, extrusion, fermentation, encapsulation); sensory attributes and consumer acceptance. 2. Efficacy, effectiveness, and health outcomes: Evidence of biological and functional efficacy; biomarker selection and measurement challenges; translation of efficacy findings from controlled settings to real-world effectiveness; longitudinal and population-level health impacts.3. Delivery platforms and food vehicles: Selection of appropriate vehicles (e.g., flour, oil, stock cubes, condiments) for fortification; case studies of scalable delivery models in diverse market contexts; integration into existing food systems and supply chains; consideration of the roles of institutional (e.g UNICEF) and commercial markets (consumers) in reaching target populations.4. Regulatory, standards, and labelling frameworks: Development and harmonisation of technical standards; national and regional policy frameworks that guide implementation; creation of policy and labelling regulations that act as enablers of sustained implementation; alignment with trade and quality assurance systems; consumer communication and trust-building in fortified products.5. Industry engagement and business models: Cost structures and supply chain dynamics; commercial viability and market incentives; public–private partnerships and co-investment approaches; roles of local and multinational manufacturers.6. Implementation at scale and systems integration: Transitioning from pilot projects to national programmes; strategies for monitoring, compliance, and quality control; integration of regulatory systems as anchors for programme sustainability; social marketing and behaviour change initiatives; alignment with national and global nutrition agendas.7. Social-economical impact of the country: Uplift in economic growth (GDP), productivity and labour market gains, ROI; standard of living improvement, education and human capital formation; health system savings and demographic effects; intergenerational and inequality effects reduced (social mobility, income inequality etc).Both Topic Editors declare that they receive research funding from the Bill & Melinda Gates Foundation for work related to the themes in this Research Topic. Topic editors: Leif Lundin, Ingrid Appelqvist Source: https://www.frontiersin.org/research-topics/81474/multifortified-foods-at-scale-bridging-product-innovation-health-impact-and-delivery-systems-for-low--and-middle-income-countries