Are all widely consumed products good to fortify—the West and Central African bouillon cubes debate

Multiple forms of malnutrition-undernutrition, micronutrient deficiencies, and increasingly overweight/obesity-are affecting populations in West and Central Africa. To address micronutrient deficiencies, fortification of staples has been implemented, but its impact has been limited due to suboptimal reach. Consequently, fortification of bouillon cubes has been considered as an alternative vehicle to deliver micronutrients due to its wider distribution, low cost, and wide consumption allowing more equitable reach of poorer households. However, most bouillon cubes are ultra-processed foods containing additives, added sugar, trans-fats, and high salt, which have all been linked to increased risk of overweight/obesity and diet-related non-communicable diseases. In keeping with the principle of “do no harm” that has guided past fortification initiatives, a reassessment of current efforts of bouillon cube fortification is warranted. Aligning nutrition interventions to ensure that interventions addressing one form of malnutrition (micronutrient deficiencies) do not trade for another (overweight/obesity and NCDs) is critical.