Millions of children in India don’t get enough Vitamin A and Vitamin D, even though the government has guidelines to prevent this. Researchers studied whether adding these vitamins directly to everyday foods like cooking oil and milk could help. They found that fortifying oil and milk could prevent serious health problems and even save lives for children, pregnant women, and elderly people. The good news? Adding vitamins to oil and milk costs less money than giving people vitamin supplements, and it reaches more people because almost everyone uses these foods.

The Quick Take

  • What they studied: Whether adding Vitamin A and Vitamin D to cooking oil and milk is a good way to prevent vitamin deficiencies in India, and whether it’s worth the cost compared to giving people vitamin pills
  • Who participated: The study looked at data for children under 5 years old, pregnant women, women of childbearing age, and elderly people across India. No specific number of people were directly tested; instead, researchers used health information already collected about vitamin deficiencies in India
  • Key finding: Adding vitamins to oil and milk could prevent over 1.1 million years of lost life from Vitamin A deficiency and nearly 100,000 years of lost health from Vitamin D deficiency. It would cost about 17.4 million dollars total, making it very affordable compared to giving everyone vitamin supplements, which would cost 26 million dollars
  • What it means for you: If you live in India or a similar country, fortified oil and milk could be an easy way to get more Vitamin A and D without taking pills. However, this is a government-level recommendation, not something individuals need to do on their own. Talk to your doctor about whether you or your family need extra vitamins

The Research Details

Researchers didn’t test people directly. Instead, they used existing health data about how many people in India have Vitamin A and D deficiencies and how serious these deficiencies are. They then calculated what would happen if the government added these vitamins to cooking oil and milk that people already use every day.

They compared two main approaches: (1) giving vitamin A pills to children and pregnant women, and (2) adding vitamins to oil and milk for children, pregnant women, women of childbearing age, and elderly people. For each approach, they figured out how many health problems could be prevented and how much it would cost.

The researchers used something called ‘DALYs’ (Disability-Adjusted Life Years) to measure health benefits. This is a way of counting both years of life lost from death and years lived with illness or disability. They estimated that Vitamin A deficiency causes 4%, 12%, or 23% of deaths depending on the situation, and they used international health data to estimate other health problems caused by these vitamin deficiencies.

This type of study is important because it helps governments decide how to spend health money wisely. Instead of testing on people (which would be expensive and take years), researchers can use existing data to predict what would work best. This approach is especially useful for big programs that affect millions of people, like adding vitamins to foods everyone eats

This study used data from trusted international health sources (the Global Burden of Disease database), which is a strength. However, the study didn’t directly measure whether fortified oil and milk actually work in real life—it predicted what would happen based on assumptions. The actual results might be different depending on whether people actually eat enough of the fortified foods and whether the fortification is done correctly. The study also didn’t account for other factors that might affect whether people get enough vitamins, like poverty or food access

What the Results Show

Adding Vitamin A to oil could prevent over 1.1 million years of life lost from death (at the highest estimate of 23% reduction in deaths). It could also prevent about 28,500 years lived with disability or illness from Vitamin A deficiency. Adding Vitamin D to milk could prevent about 99,000 years lived with disability or illness.

The cost to fortify oil and milk would be about 17.4 million dollars total (7.6 million for oil, 9.8 million for milk). This is much cheaper than the 26 million dollars it would cost to give vitamin supplements to all the children and pregnant women who need them.

Because fortification is cheaper and reaches more people (including elderly people and all women of childbearing age, not just pregnant women), the researchers concluded it’s a better long-term solution. The ‘cost-effectiveness ratio’ of 150 means that for every unit of health benefit gained, the cost is very reasonable compared to other health programs.

The biggest advantage of fortification is that it works automatically—people don’t have to remember to take pills or go to health clinics. Since almost everyone in India uses cooking oil and milk, this approach could reach millions of people who might not otherwise get vitamin supplements.

The study found that fortification could help multiple groups of people, not just children. Pregnant women, women of childbearing age, and elderly people would all benefit from fortified oil and milk. This is important because vitamin deficiencies affect different age groups in different ways—for example, Vitamin D is especially important for bone health in elderly people. The study also showed that fortification could prevent both deaths and illnesses, making it valuable for overall health improvement

India already has a program giving Vitamin A supplements to children, but millions of children still don’t get enough vitamins. This study suggests that adding fortification to supplements (rather than replacing supplements) could help reach more people. Previous research has shown that fortification programs work well in other countries, and this study confirms that India could benefit from a similar approach. The cost-effectiveness of this program is comparable to or better than other health programs that governments typically fund

The biggest limitation is that this study predicted what would happen—it didn’t actually test fortified oil and milk with real people. The actual results could be different. The study also assumed that people would eat enough fortified oil and milk to get the vitamins they need, but some people might not have access to these foods or might not eat enough. The study didn’t look at whether fortification could cause problems if some people got too many vitamins. Additionally, the study focused only on Vitamin A and D deficiencies and didn’t consider other nutritional problems in India. Finally, the cost estimates might change depending on how the fortification is done and where the food is produced

The Bottom Line

If you live in India or a country considering this program: (1) Support government fortification of oil and milk as a public health measure—this is a reasonable, cost-effective approach. Confidence level: High. (2) Continue eating oil and milk as part of a balanced diet, as fortification will add vitamins to foods you likely already eat. Confidence level: High. (3) Don’t stop taking vitamin supplements if your doctor prescribed them, as fortification alone may not be enough for people with severe deficiencies. Confidence level: High. (4) If you’re pregnant, planning to become pregnant, or have a child under 5, talk to your doctor about whether you need additional vitamin supplements beyond what fortified foods provide. Confidence level: High

This research is most important for: Government health officials and policymakers in India and similar countries deciding how to prevent vitamin deficiencies. Parents and caregivers of young children, pregnant women, and women planning to become pregnant. Elderly people, who often have vitamin deficiencies. People living in areas where vitamin supplements are hard to get or afford. This research is less directly relevant for: People in wealthy countries with strong supplement programs already in place. People who already get enough vitamins from their diet. However, the approach could still be useful in other countries facing similar vitamin deficiency problems

If India implements this fortification program, benefits would appear gradually. Some health improvements (like better immune function from Vitamin A) could appear within weeks to months. More serious health benefits (like preventing childhood blindness or reducing deaths) would become visible within 1-2 years as the program reaches more people. Long-term benefits for bone health (from Vitamin D) and prevention of chronic diseases would take several years to fully appear. The program would need to continue long-term to maintain these benefits

Want to Apply This Research?

  • Track daily oil and milk consumption in cups or tablespoons. Set a goal of consuming at least 2 tablespoons of fortified cooking oil and 1 cup of fortified milk daily, and log actual consumption. This helps ensure you’re getting enough of the fortified foods to benefit from added vitamins
  • Switch to fortified oil and milk products when available. Check labels for ‘fortified with Vitamin A’ and ‘fortified with Vitamin D’ when shopping. Use the app to set reminders to include these foods in meals—for example, a reminder to use oil when cooking lunch or to drink milk with breakfast
  • Track consumption weekly and note any health improvements like better energy levels, improved digestion, or stronger nails (signs of better nutrition). For pregnant women or parents of young children, monitor growth and development milestones. If using the app long-term, compare consumption patterns month-to-month to ensure consistency. Share data with your doctor at annual checkups to discuss whether additional supplements are needed

This research presents a cost-effectiveness analysis and does not constitute medical advice. The findings are based on mathematical models and existing health data, not direct testing in people. Individual vitamin needs vary based on age, health status, diet, and other factors. If you or your family members have symptoms of vitamin deficiency (such as poor wound healing, bone pain, vision problems, or frequent infections), consult a healthcare provider for proper diagnosis and treatment. Pregnant women, children under 5, and people with certain medical conditions should discuss vitamin supplementation with their doctor rather than relying solely on fortified foods. This study is relevant primarily for government health policy decisions in India and similar countries; individual recommendations should come from qualified healthcare professionals