Conventional wisdom suggests that a selection of a variety of foods, as indicated by the USDA Food Guide Pyramid, is the best method to provide a balanced diet containing all the nutrients the body needs for growth and function. However, many food processing procedures used today strip essential vitamins and minerals from the food ingredients. Therefore, fortification with those vitamins and minerals may be necessary to provide a balanced diet.
Fortification may also occur to provide people with nutrients that are lacking in people’s normal choices of foods. Fortification can vary, from vitamins to minerals, even beneficial plant and flower extracts. One such nutrient is elemental iron. Iron deficiency anemia (IDA) is the most prevalent nutritional disorder in the world. Physiological effects of IDA include impaired cognitive development, lowered work capacity and reduced resistance to childhood infectious diseases. The economic loss due to iron deficiency in South Asia alone is tremendous, with close to $4.2 billion lost annually. In order to combat such preventable losses, an increase in iron fortification in cereals in North America and parts of Europe has occurred in the past several years.
Another well-known nutrient recently introduced to breads and cereals to fortify the American diet is folic acid. Folic acid is a B vitamin that has been shown to reduce a woman’s risk of giving birth to a child with spina bifida or other neural tube defects. A recent study in the Journal of the American Medical Association (JAMA) found that folate deficiency was associated with a 50% increase in risk of early miscarriage.
However, fortification is not just for major health issues anymore. A new trend is to “fortify” for optimal performance of our bodies. In addition, breads and cereals are not the only food products that are being “nutritionally enhanced.” Bottled water is now often “fortified” with vitamins, minerals or botanical extracts. Water containing these nutrients and flavors may still be called “water,” if it is calorie-free and sugar-free. Even though these products can still be called “bottled waters,” the name of the product must list all of the ingredients that are put into the bottled water. For example, one bottled water could contain an essence of lemon and vitamins A, C, D and so on. But every added ingredient has to be in the name of the product and the product must contain an ingredients list on the label. Flavors, extracts or essences derived from spices or fruits must comprise less than 1% of the final weight of the product, or the product becomes a “soft drink.” As research uncovers more of the complex interactions between nutrients and health maintenance, food and beverage fortification may become more of a standard practice than an exception to the rule.
In anticipation of this largely unregulated practice, the European Commission has published a draft proposal for a directive on the addition of vitamins, minerals and other substances to food. The proposal will cover fortification or enrichment of foods, as well as replacement of nutrients lost during storage, handling and manufacturing and for producing substitute foods, so they meet the nutritional value of those they are to resemble. The proposal will set levels of purity and maximum levels for nutrients. Strict labeling rules will also be defined, so that the product labels will not mislead or deceive the consumer as to the nutritional merit of the added nutrients. A draft proposal for the Directive (SANCO/329/03) has been published, with the UK’s Food Standards Agency calling for comments prior to the March meeting held in Brussels.