Does fortification work outside of the US?
Food fortification has been an extremely powerful public health tool, improving the nutrient intakes of the public and preventing nutritional deficiencies. Much of the data we refer to in TalkingNutrition is based on information in the United States, however today we have new data from Ireland showing a similar beneficial impact of fortification.
Today, Hennessy and colleagues published a report on the impact of voluntary food fortification practices in Ireland from the late 1990’s through 2010 (fortification in Ireland is slightly different than in the United States, where fortification of specific staple foods has been mandatory since the first half of the 20th century). The researchers used two national dietary intake surveys, the North/South Ireland Food Consumption Survey (NSIFCS) performed between 1997-1999, and the National Adult Nutrition Survey (NANS), performed between 2008-2010.
Much like in the United States, it was found that fortified foods are major contributors to nutrient intakes in Ireland. Fortified foods such as ready-to-eat cereals, cereal bars, juices and sports drinks increased substantially between the 1997-1999 and 2008-2010 survey periods. Fortified foods provided more than 10% of the public’s intake of nutrients such as Thiamin, Niacin, Riboflavin, Folate, and Iron. In the latter NANS survey, fortification contributed significantly to the intake key shortfall nutrients such as Vitamin D and Vitamin E. Furthermore, key “at-risk” populations such as women of childbearing age were identified as specifically benefitting from fortification practices, as fortified foods made large contributions towards the intake of important nutrients such as Iron and Folate. Last but not least, the authors noted that fortification did not result in intakes of these nutrients over the tolerable upper intake level (UL), underscoring the safety of fortification.
It’s not the time to rest on our heels, since despite the improvement in nutrient intakes that fortification has provided, significant nutrient gaps still exist among Irish adults. For instance, more than 10% of % of adults were not meeting the recommended intake for Vitamin A, and more than 90% of Irish adults were not meeting the recommended intake for Vitamin D (it’s worth noting here that the EAR cutoffs used in this report differ from the IOM established values used in the United States).
Once again, we see how fortified foods improve nutrient intakes and benefit public health. Thanks to data such as these, the scientific community is becoming increasingly accepting of the beneficial role that fortified foods play in nutrition. Fortified foods remain essential tools in the battle to end nutritional inadequacy in the modern world.
Hennessy A, et al. Impact of voluntary food fortification practices in Ireland: trends in nutrient intakes in Irish adults between 1998-9 and 2008-10. Br J Nutr 2014; epub ahead of print.
Fulgoni VF 3rd, et al. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr 2011; 141(10): 1847-1854.