Exploring Nutrition and Health Outcomes of Biofortification in LMICs: A Scoping Review of Interventions Targeting Micronutrient Deficiencies

Hidden hunger, underpinned by widespread micronutrient deficiencies, remains a pressing public health concern in Low- and Middle-Income Countries (LMICs). This review maps existing biofortification interventions in LMICs and their reported outcomes, whilst critically evaluating which approaches demonstrate measurable improvements in nutritional and health status. It further considers the feasibility of different biofortification strategies, with the aim of informing future implementation and research priorities to mitigate hidden hunger in LMIC contexts. The scoping review was conducted in accordance with the PRISMA-ScR guidelines. Literature search were conducted from five databases included Scopus, Pubmed, Taylor & Francis, Google Scholar and ProQuest. Relevant studies were identified through structured database searches employing Boolean operators, and the synthesis focused on intervention types, measurement methods, and reported nutrition and health outcomes. In total, 42 studies published between 2006 and 2025 were included, spanning 22 LMICs across Africa, Asia, and Latin America. The interventions predominantly centred on the biofortification of staple crops such as maize, rice, cassava, sweet potato, and legumes, with evidence indicating improvements in dietary adequacy and micronutrient status, although data on long-term health effects and cost-effectiveness remain limited. This study highlight turning points for biofortified strategies for alleviating hidden hunger in LMICs through; (1) optimize the nutrients in food matrix and develop processing strategies to enhance the bioavailability of biofortified intervention, (2) Strenghthening farmers community by providing counseling and education how to conduct and ensure the sustainability of programs, and (3) Conduct the dietary intake assessment for assessing nutritional status to measure the effectiveness of programs.