Overview

Food fortification represents a proven, cost-effective strategy to address low calcium intake at the population level. Research demonstrates that calcium-fortified foods contribute to improved height in children and enhanced bone mineral density across all age groups. Unlike targeted supplementation programs, fortification provides a unique advantage for maternal health—it reaches women before pregnancy and continues throughout gestation, which is critical since early pregnancy identification remains challenging in many regions. This population-level intervention helps improve pregnancy outcomes by ensuring adequate calcium intake during crucial developmental periods.

Data Source

This visualization comes from the Global Fortification Data Exchange, which systematically compiles and validates fortification legislation information for 196 countries worldwide. The map illustrates countries with and without calcium fortification legislation and provides information on the regulatory approaches (mandatory versus voluntary fortification) and specified calcium fortificant levels across five key food vehicles: maize flour, cooking oil, rice, salt, and wheat flour.

Strategic Applications

Policymakers and nutrition program planners can use this map to identify countries with existing calcium fortification legislation, analyze standard fortification levels, and evaluate which food vehicles are currently used as calcium delivery mechanisms. When integrated with calcium intake data and health outcome metrics, this visualization serves as a critical planning tool for designing complementary calcium interventions, establishing evidence-based fortification standards, and identifying policy gaps in regions with high calcium deficiency.

Further Reading

• Global Fortification Data Exchange. Access database
• Knight, F., Ferguson, E. L., Rana, Z. H., Belizan, J., Gomes, F., Bourassa, M. W., … & Cormick, G. (2023). Including calcium‐fortified water or flour in modeled diets based on local foods could improve calcium intake for women, adolescent girls, and young children in Bangladesh, Uganda, and Guatemala. Annals of the New York Academy of Sciences, 1526(1), 84-98. View article
• Bourassa, M. W., Abrams, S. A., Belizán, J. M., Boy, E., Cormick, G., Quijano, C. D., … & Weaver, C. M. (2022). Interventions to improve calcium intake through foods in populations with low intake. Annals of the New York Academy of Sciences, 1511(1), 40-58. View article

Last updated: 8/1/25