Should the Nutrition Facts panel drive food fortification practices?
You may already be aware that the Food and Drug Administration (FDA) has proposed numerous revisions to the ever present “Nutrition Facts” panel present on the side of nearly all foods you buy. In the Personal Health section of Sunday’s New York Times, author Jane Brody wrote about these revisions – praising some changes yet also pointing out areas which she felt that the proposal left things to be desired. Relying on a quote from former FDA commissioner Dr. David Kessler, Ms. Brody was specifically critical of what she felt was a lack of promotion of “real foods” in the new Nutrition Facts panel, saying that “Instead, the new label, like the current one, would focus on specific nutrients and give ‘food companies an incentive to fortify their products so they can make claims such as added fiber’… ”. Given that the average daily intake of dietary fiber is roughly half of the recommendation in certain age/gender groups – why is fortification being painted as a bad thing?
Should the Nutrient Facts panel act as a way to incentivize manufacturers to fortify their products with essential nutrients? Absolutely. The nutrient facts panel helps to inform consumers about which nutrients they should try to include (or in some cases, limit) in their diet. And by helping to guide consumer behavior, and the nutrient facts panel ultimately helps to guide the food industry in their goal of developing healthier products for consumers. Fortification with specific nutrients, like dietary fiber, is a simple and effective way for manufacturers to improve the nutritional profile of a food product.
Without question, fortification of foods with essential nutrients has been a phenomenally successful public health practice. Nutrient fortification is responsible for the near elimination of classic nutrient deficiency diseases such as pellagra (caused by deficiency of the B-vitamin niacin). A more recent example would be that of folic acid fortification, which has drastically reduced the incidence of neural tube defects in the United States. Today, nutrient fortification remains an effective way to improve the intakes of essential nutrients and to limit dietary inadequacies. In the United States, fortified foods have a major influence on the intake of essential nutrients including Vitamin A, Iron, and Thiamin. Fortification has also been shown to improve the intakes of key nutrients among specific at-risk populations, such as teenage girls. To say that fortification has been successful is merely an understatement – to imply that fortification is somehow detrimental to consumers is simply incorrect.
In a recent position paper, the American Society for Nutrition has recognized the positive impact that processed foods make to the American diet, and this is in large part to voluntary fortification efforts. For example, ASN cites statistics showing that processed foods contribute 55% of the total intake of important nutrients such as dietary fiber, among others. Consuming adequate amounts of fiber in the diet is extremely important, as fiber is well known for its role in supporting healthy digestion as well as reducing the risk of heart disease by lowering cholesterol. Thanks in no small part to fortification, processed foods help the American diet by providing additional sources of essential nutrients in the food supply.
Bottom line: Consumers should look for nutrient dense foods that contain adequate amounts of important nutrients, no matter whether they are processed or not. Meeting the dietary recommendations for key nutrients, like dietary fiber, is critical for maintaining health.
Brody, Jane. Revised nutrition labels still won’t tell whole story. New York Times, Personal Health Section. October 26, 2014.
Berner LA, et al. Fortified foods are major contributors to nutrient intakes in diets of US children and adolescents. J Acad Nutr Diet 2014; 114(7): 1009-1022.
Fulgoni VL III, et al. Foods, fortificants, and supplements: where do Americans get their nutrients? J Nutr 2011; 141(10): 1847-1854.
King DE, et al. Trends in dietary fiber intake in the United States, 1999-2008. J Acad Nutr Diet 2012; 112(5): 642-648.
Park YK, et al. Effectiveness of food fortification in the United States: the case of pellagra. Am J Public Health 2000; 90(5): 727-738.
Weaver CM, et al. Processed foods: contributions to nutrition. Am J Clin Nutr 2014; 99(6): 1525-1542.
Wolever TM, et al. Physicochemical properties of oat beta-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial. Am J Clin Nutr 2010; 92(4): 723-732.