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Food fortification is the public health policy of adding micronutrients (essential trace elements and vitamins) to foodstuffs to ensure that minimum dietary requirements are met.
Simple diets based on staple foods with little variation are often deficient in certain nutrients, either because they are not present in sufficient amounts in the soil of a region, or because of the inherent inadequacy of the diet. Addition of micronutrients to staples and condiments can prevent large-scale deficiency diseases in these cases.
Introduction
Several ranges of food supplements are recognised:
- additives which repair a deficit to "normal" levels
- additives which appear to enhance a food
- supplements taken in addition to the normal diet
Many physicians today disagree with the premise that foodstuffs need supplementation, but accept that - for example - added calcium may provide benefit, or that adding folic acid may correct a nutritional deficiency especially in pregnant women.
On a more controversial level, but well founded in scientific basis, is the science of using foods and food supplements to achieve a defined health goal. A common example of this use of food supplements is the extent to which body builders will use amino acid mixtures, vitamins and phytochemicals to enhance natural hormone production, increase muscle and reduce fat.
Moving on from this reasonably accepted usage, there is increasing evidence for the use of food supplements in established medical conditions. This nutritional supplementation using foods as medicine (nutraceuticals) has been effectively used in treating disorders affecting the immune system up to and including cancers. This goes beyond the definition of "food supplement", but should be included for the sake of completeness.
Food supplements
There are several main groups of food supplements which can be considered:
Examples of fortified foods
Iodised salt has been used in the United States since before World War II.
Folic acid is added to flour in many industrialized countries, and has prevented a significant number of neural tube defects in infants[1]. It is, however, not uniform in its application, with more intake of folic acid through fortified flour among those who were already receiving high amounts through their diet[2].
Niacin has been added to bread in the USA since 1938 (when voluntary addition started), a programme which substantially reduced the incidence of pellagra.[3]
Vitamin D is added to a few foods (especially margarine).
Fluoride salts are added to water and toothpastes to prevent tooth decay. Water fluoridation is a controversial topic.
Calcium is frequently added to fruit juices, carbonated beverages and rice.
"Golden rice" is a variety of rice which has been genetically modified to increase its beta carotene content.
A wide range of iron compounds, including ferrous sulfate, ferrous fumarate and even elemental iron powder[4] are added to food (usually cereal flours, but also table salt, milk and condiments) in a number of countries to prevent iron deficiency anemia. Although iron intake is often sufficient in developing countries, the bioavailability of the dietary iron is low, due to such factors as polyphenols and phytic acid binding the iron and preventing its absorption.[4] Major challenges in iron fortification are to avoid undesirable changes in the appearance and taste of the food, and to target the population segment that needs the fortification the most.[4]
See also
References
- ^ Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LY (2001). "Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects". JAMA 285 (23): 2981–6. doi:10.1001/jama.285.23.2981. PMID 11410096, http://jama.highwire.org/cgi/reprint/285/23/2981.pdf.
- ^ Crane NT, Wilson DB, Cook DA, Lewis CJ, Yetley EA, Rader JI (1995). "Evaluating food fortification options: general principles revisited with folic acid". American journal of public health 85 (5): 660–6. PMID 7733426, http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1615413&blobtype=pdf.
- ^ Park YK, Sempos CT, Barton CN, Vanderveen JE, Yetley EA (2000). "Effectiveness of food fortification in the United States: the case of pellagra". American journal of public health 90 (5): 727–38. PMID 10800421, http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1446222&blobtype=pdf.
- ^ a b c Hurrell RF (1997). "Preventing iron deficiency through food fortification". Nutr. Rev. 55 (6): 210–22. PMID 9279057.
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