The need for a profound food system transformation has never been greater. The growing burden of malnutrition has become the new normal, with two billion people who are overweight, over 140 million children under five who are stunted and over two billion people affected by hidden hunger. Food fortification has been recognized as a cost-effective strategy to address micronutrient deficiencies. Small and medium enterprises (SMEs) play a strategic role in the food supply chain in low- and middle-income countries, accounting for over 80% of food sales. It is therefore critical to create an enabling environment to facilitate SMEs’ involvement in food fortification practices as a potential solution to tackle all forms of malnutrition. This review highlights SMEs’ relevance as agents of change in the food system through food fortification practices and their indirect yet key role in producing nutritious, tasty and affordable foods. It discusses their challenges (e.g., access to long-term finance, sustainable technical assistance, limited capacity), presents solutions and discusses how different actors can help SMEs to overcome these challenges. Furthermore, it presents a relevant public–private partnership case study to demonstrate how SMEs can address the growing burden of malnutrition through food fortification practices, nutrient profiling schemes and demand generation.

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Climate change, rapid urbanization, war, and economic recession are key drivers of the current food systems’ disruption, which has been exacerbated by the COVID pandemic. Local, regional, and global food systems are unable to provide consumers with nutritious and affordable diets. Suboptimal diets exacerbate the triple burden of malnutrition, with micronutrient deficiencies affecting more than two billion people, two billion people suffering from overweight, and more than 140 million children who are stunted. The unaffordability of nutritious diets represents an obstacle for many, especially in low- and middle-income countries where healthy diets are five times more expensive than starchy staple diets. Food system transformations are urgently required to provide consumers with more affordable and nutritious diets that are capable of meeting social and environmental challenges. In this review, we underline the critical role of innovation within the food system transformation discourse. We aim to define principles for implementing evidence-based and long-term food system innovations that are economically, socially, and environmentally sustainable and, above all, aimed at improving diets and public health. We begin by defining and describing the role of innovation in the transformation of food systems and uncover the major barriers to implementing these innovations. Lastly, we explore case studies that demonstrate successful innovations for healthier diets.

Climate change, rapid urbanization, war, and economic recession are key drivers of the current food systems’ disruption, which has been exacerbated by the COVID pandemic. Local, regional, and global food systems are unable to provide consumers with nutritious and affordable diets. Suboptimal diets exacerbate the triple burden of malnutrition, with micronutrient deficiencies affecting more than two billion people, two billion people suffering from overweight, and more than 140 million children who are stunted. The unaffordability of nutritious diets represents an obstacle for many, especially in low- and middle-income countries where healthy diets are five times more expensive than starchy staple diets. Food system transformations are urgently required to provide consumers with more affordable and nutritious diets that are capable of meeting social and environmental challenges. In this review, we underline the critical role of innovation within the food system transformation discourse. We aim to define principles for implementing evidence-based and long-term food system innovations that are economically, socially, and environmentally sustain­able and, above all, aimed at improving diets and public health. We begin by defining and describing the role of innovation in the transformation of food systems and uncover the major barriers to implementing these innovations. Lastly, we explore case studies that demonstrate successful innovations for healthier diets.

The concept of PN calls into question the 'one-size-ts-all' approach, a common practice in public health nutrition. It starts from the premise that each individual responds uniquely to speci c foods and nutrients. PN centers around the idea that one's characteristics such as genetic makeup, microbiome and metabolic response to speci c nutrients or diets can inform the most e ective selection of health and nutrition interventions.¹ ² Sight and Life