Food fortification with micronutrients was initially justified in developed countries by lack of availability of micronutrients in staple crops, mainly due to soil exhaustion. However, in Sub-Saharan arable lands soil fatigue is not predominant and communities consume mostly home-grown organic non-processed crops. African food systems are nevertheless deeply entwined with food insecurity, driver of illnesses. Family production can promote subsistence, food stability and self-sufficiency, the main African setback being the vicious cycle of poverty and the lack of dietary variety, contributing to malnutrition. Poverty reduction, and women's education, are significant strategies for reducing child and adolescent undernourishment. Fortification of foods consumed daily by individuals makes sense and can minimize if not entirely eliminate deficiencies. Mass fortification in Sub-Saharan Africa with single micronutrients is however controversial working in synergy among each other and the food matrix, for optimal absorption and metabolism. Since the causes of malnutrition are many, caused by diverse, unequal and unjust food distribution, interrelated with political, social, cultural or economic factors, education status of the population, season and climatic changes, and effectiveness of nutrition programmes, just food fortification cannot solve the composite of these elements. Further, compulsory fortification is excessive, unproductive and likely harmful to human health, while many challenges remain in accessing quality of premixes. However, aiming at dietary diversification is the best approach of increasing trace elements intake from commonly accessible and easily available food sources.