In today’s health-conscious landscape, the practice of adding extra ingredients to processed foods is the subject of intense scrutiny, with many consumers arguing that foods are more nutritious without a lot of (often artificial) additives. But what about things that are added to foods for the purpose of promoting better health and nutrition?
Welcome to the world of fortified foods. Described by some as one of the most successful public health interventions in American history, fortification helps ensure that people get an adequate supply of vital nutrients that may not be readily available from other sources. If you’ve spent your life free from diseases like goiter or rickets, you likely have fortification to thank. Read on to learn more.
What exactly are fortified foods?
To produce fortified foods, nutrients that do not naturally occur in those foods are added during processing. One of the most common examples of fortified food is table salt, which has contained added iodine since the 1920s.
Why are some foods fortified?
In the early 20th century, US scientists and health care professionals started to connect the dots between nutritional deficiencies and a number of chronic health problems. For example, a huge percentage of the population in the Great Lakes and Appalachia regions at this time developed goiter, an abnormal enlargement of the thyroid gland. Realizing that this problem was caused by insufficient iodine intake (in these regions, levels of iodine in the soil are naturally low and iodine-rich foods like seafood are not common) the US began to fortify table salt with iodine in 1924. Today, as a result of this move, goiter has been virtually eradicated.
Fortification became even more widely used in the 1930s and 40s when concerns grew about the poor nutritional status of many of the young men joining the army during World War II. In response, the US began adding vitamin D to milk to prevent rickets (a childhood skeletal disorder that leaves the bones soft and weak), and other nutrients to flour to help combat prevalent early 20th-century health conditions like beriberi (which affects the cardiovascular system) and pellagra (a vitamin deficiency characterized by dermatitis, diarrhea, and dementia).
Today, even though the average diet is much healthier than it was a century ago, the need to fortify foods is not over. For example, in the early 1990s, scientists made the link between folic acid deficiency in pregnant women and a high risk of a particular type of birth defect called neural tube defects (NTD). In 1998 the FDA made it mandatory to add folic acid and certain other nutrients to enriched cereal grain products, resulting in a 26 percent decline in the number of NTD-affected pregnancies in the US.
What kinds of nutrients are added during fortification?
The nutrients that are added to foods during fortification include vitamins, minerals, and trace elements, all of which promote good health, help prevent disease, and support the body’s vital physiological functions. Some examples include:
Vitamin A—Vitamin A improves immune function and has been associated with healthy vision. It is often added to milk and breakfast cereal.
B vitamins—The B group of vitamins includes thiamin (B1), riboflavin (B2), niacin (B3), and folic acid or folate (B9). This class of vitamins plays an important role in cell metabolism, red blood cell production, and nervous system maintenance, and it also helps your body produce energy. B vitamins are added to enriched flour, enriched white rice, and breakfast cereal.
Vitamin C—In addition to slowing cellular aging, vitamin C boosts immune function and helps to prevent infection. Like vitamins A and B, it is often added to breakfast cereal.
Vitamin D—Vitamin D promotes good bone health by enhancing intestinal absorption of calcium, magnesium, and zinc. Foods fortified with vitamin D include milk, plant-based milks, fruit juice (especially orange juice), breakfast cereal, and baby formula. Interestingly, vitamin D is underconsumed by Americans as it does not naturally occur in many foods; consequently, fortified foods tend to be our most important source of vitamin D.
Vitamin E—An important part of immune and neurological function, vitamin E also helps reduce inflammation. It too is often added to breakfast cereal.
Calcium—A vital nutrient for muscle contraction and good bone health, calcium is added to beverages like milk, plant-based milks, and fruit juice, as well as foods like breakfast cereal.
Are fortified foods and enriched foods the same thing?
The terms “fortified foods” and “enriched foods” are often used interchangeably, but they don’t have quite the same meaning. Fortified foods, as described above, have nutrients added that do not occur naturally in the foods. Enriched foods, on the other hand, do contain these nutrients, but because they are typically lost during handling, processing, or storage, they must be added back in. Refined wheat flour, which often has added B vitamins and iron, is a common example of an enriched food.