A woman shopping in a Lagos supermarket. Photo by Ninthgrid, Free to Use.

When was the last time you checked a food label before taking a bite? If you’re like most people in West Africa, the answer might be rarely — or only when something looks suspicious.

It’s no surprise that the words “fortification” and “food labels” sound more like something from a high school chemistry class than an everyday concern. In the bustling markets of Lagos and across Africa, food choices are driven by price, availability, and accessibility and not by micronutrient content or ingredient lists. 

In a 2019 consumer survey assessing the use of nutrition labels among 420 randomly selected adults in Lagos, Nigeria, only 21 respondents (5 percent) demonstrated a solid understanding of food label information. Less than one-third of the respondents — 123 individuals (29.2 percent) reported making regular use of nutrition labels when purchasing food. Meanwhile, a striking 373 respondents (88.8 percent) said they either never or only occasionally read nutrition labels. This disconnect wasn’t because they don’t care about their health, but rather a mix of factors such as brand familiarity, limited time to read labels, disinterest, and in many cases, a lack of nutrition education. For most, food is still primarily understood through the lens of taste and affordability — not nutritional value.

But here’s the problem: in a region where malnutrition and diet-related illnesses are growing threats, understanding what’s in our food is no longer optional. It’s essential. So, how well are these West African countries doing when it comes to food fortification and labelling? And more importantly, is any of it making a difference?

Political map of West Africa, 2005. Image by UN from Wikimedia Commons (Public domain).

From Nigeria’s jollof wars to Ghana’s love for waakye, the region’s diverse culinary traditions are a source of pride. But while the flavours are rich, less attention is placed on the nutrition behind foods, especially for adolescents who need the right nutrients to fuel their growth and development.

With a global population of 1.3 billion, adolescents currently make up 16 percent of the world’s population — a figure projected to rise to 24 percent by 2030. In Sub-Saharan Africa alone, an estimated 250 million adolescents live on a continent that holds the title of the youngest population in the world. At this critical growth stage (ages 10 to 19), what adolescents eat (or don’t eat) plays a massive role in health outcomes. Malnutrition, however, remains a global concern during adolescence.

Micronutrient deficiencies among adolescents in West Africa

Malnutrition is not always about empty plates; it often refers to the imbalance between the nutrients the body needs and the nutrients it gets. It can take the form of undernutrition, micronutrient deficiencies, or even obesity. These imbalances can have lasting consequences among adolescents, whose bodies are undergoing rapid physiological changes.

Micronutrients, though needed in small amounts, play an outsized role in shaping adolescent health. They are essential for cognitive development, bone strength, hormonal balance, and overall well-being. Nutritionists say that for adolescent girls, micronutrients such as folate, calcium, multivitamins, iron, iodine, potassium, and sodium must be present in foods and dietary intake. 

Yet, deficiencies in these key micronutrients remain a global concern. According to the US National Library of Medicine, iodine deficiency alone affects approximately 2 billion people worldwide, particularly in Global Majority countries. It is considered the leading cause of preventable but irreversible brain damage in fetuses, cognitive delays in children, and mental health problems in adults. 

Food fortification in West Africa

Ghana, an agrarian country, devotes much of its rural land to food crop production, including staples such as maize, yam, cassava, plantain, and beans, alongside a significant livestock farming sector. Yet, despite this agricultural richness, dietary diversity remains inadequate, particularly among adolescents. A heavy reliance on starchy staples, compounded by unhealthy eating habits like meal skipping and frequent snacking on processed foods, contributes to micronutrient deficiencies, increasing the risk of anaemia in adolescents.

To combat the high prevalence of anaemia among adolescent girls, Ghana launched the Girls’ Iron-Folic Acid Tablet Supplementation (GIFTS) Programme in December 2018. This nationwide initiative provides free weekly iron-folic acid (IFA) supplements to both in-school and out-of-school adolescent girls, to raise their haemoglobin levels and reduce anaemia risk.

Even though Ghana is not on track to meet the World Health Assembly’s global nutrition target for 2025 in reducing anaemia among women of reproductive age, other projects are underway to deliver targeted and integrated nutrition programmes for those who need it most.

Meanwhile, Nigeria’s approach to adolescent nutrition intertwines nutrition with education policy. While UNICEF reported a significant increase in undernourishment among adolescent girls from 5.6 million in 2018 to 7.3 million in 2021, in terms of global targets for nutrition for 2025, Nigeria appears to have made slight progress. 

In 2001, Nigeria launched its National Policy on Food and Nutrition to address malnutrition, particularly among vulnerable groups, including adolescents. The policy promoted dietary diversification and food fortification and enforced legislation on universal salt iodization (USI) at 50mg/kg to combat widespread iodine deficiency. By 2005, Nigeria became the first African country to be certified as USI compliant after achieving 98 percent household coverage of iodized salt.

Due to poor implementation of the previous policy, Nigeria adopted a revised 10-year policy framework (2016–2025) to improve delivery and impact. This blueprint, however, is under review again, driven by a wave of emerging nutritional challenges.

Although Nigeria mandates large-scale fortifications of foods (LSFF), including iron in wheat flour, and vitamin A in cooking oils, surveillance of the well-being and nutrition of its more than 41 million adolescents remains largely underestimated and unprioritized.

In 2021, Nutrition International (NI), in partnership with UNICEF, distributed over 76 million vitamin A capsules across Nigeria’s 36 states and the Federal Capital Territory. As part of its home fortification project, NI also delivered over 8 million sachets of micronutrient powders (MNPs) and small-quantity lipid-based nutrient supplements (SQLNS) to support vulnerable children.

But the broader dietary trends remain troubling. A global review on adolescent nutrition in Global Majority countries reported a low intake of vegetables, fruits, and animal protein, alongside a surge in processed snack consumption. Nigeria mirrors this pattern, as fast food establishments continue to rise in popularity, especially among youth.

Elsewhere in West Africa, countries like The Gambia face the double burden of malnutrition as persistent undernutrition coexists with rising obesity rates. According to the Global Nutrition Report, while efforts to reduce anaemia among women of reproductive age have seen some progress, there is growing concern over the increasing prevalence of overweight and obesity among girls aged 5 to 19.

Harmonizing food fortification standards in West Africa

Regionally, efforts have been made to harmonize food fortification standards across West Africa. The Economic Community of West African States (ECOWAS) in 2007 developed common standards for fortifying vegetable oils with vitamin A and wheat flour with iron and folic acid. However, implementation varies among countries. For example, while Nigeria mandates the fortification of sugar and maize flour with vitamin A, The Gambia has yet to adopt similar mandatory measures.

Fortifying foods is “amazingly inexpensive,” according to Shawn Baker, who served as USAID’s chief nutritionist from 2020 to 2023. He described it as an incremental cost that many food processing companies readily embrace once they understand the health benefits relative to the minor expenses involved.

Fortifying staple foods is described as one of the highest-return investments in global development, and can bridge nutritional gaps, particularly for adolescents, women, and low-income households.  As governments, producers, and communities work to shape the food systems in the region, the question is no longer whether fortification works, but rather if we are willing to make it work for everyone.

This article was produced as part of the African Union Media Fellowship with support from Nutritional International.