Fortified Foods, Friend or Foe?

By: Megan Meyer, Microbiology and Immunology Doctoral Student, University of North Carolina at Chapel Hill

Recently, the Environmental Working Group (EWG) released a report titled “How Much is Too Much? Excess Vitamins and Minerals in Food Can Harm Kids’ Health.” The report claimed:

  • Many Americans, especially children, are at the risk of consuming excessive amounts of micronutrients due to increased fortified foods that contain vitamin A, niacin, and zinc.
  • The report urges the FDA to “finalize its new nutrition label and adjust the adult Daily Values and children’s Daily Values to be in line with current science”.

In order to provide context on the topic of fortification, this post will explain what you need to know about fortified food including the history of food fortification, and why it is so important to our food supply and improving public health.

What are micronutrients? Micronutrients are compounds that are required by humans for physiological functions. They include vitamins, minerals, and trace elements to prevent disease and promote human health.

  • Vitamin A-may contribute to maintenance of healthy vision; improves immune function
  • Vitamin C-may prevent infection and boost immune function; slows cellular aging
  • Vitamin D- enhances intestinal absorption of calcium, magnesium, and zinc; promotes bone health
  • Vitamin E- may halt inflammation; important for neurological function
  • Calcium- vital for muscle contraction; promotes bone health
  • Magnesium- prevents chronic disease; essential for cellular growth
  • Niacin (B3)- helps support cell growth, helps regulate metabolism
  • Zinc-aids cellular metabolism; supports normal growth and development during pregnancy; boosts immune function

Why are some foods fortified? Turns out, fortification of foods has taken place in the US since the early 20th century when scientists and health care professionals noted that nutritional deficiencies caused chronic health problems.  In 1924, iodine was added to salt as a preventative measure against goiter. In the 1930s and 1940s, milk and flour became fortified to due to an increasing concern over poor nutritional stats of young men enlisting during World War II.  Vitamin D was added to milk to prevent rickets, while thiamine, niacin, riboflavin, and iron were added to flour. The most recent micronutrient recommended to be added to foods by the FDA was folic acid in 1998 to prevent neural tube defects in developing embryos. As such, the US has a long standing history with fortified foods that have been shown to both prevent against diseases and promote public health.

Why should I eat fortified food?  Fortified foods play an important role in meeting nutrient needs and improving public health. Data from the National Health and Nutrient Examination Survey (NHANES) demonstrate that Americans over the age of 2 do not receive key nutrients from food alone. A recent study demonstrated that the majority of the US population do not ingest the daily requirements of vitamin D, and vitamin E, and more than one third of Americans do not meet the requirements for vitamin A, calcium, and magnesium. Furthermore, research has shown that without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary References Intake. These studies highlight that many Americans do not reach the daily requirements of many essential nutrients, which may contribute to chronic health problems. This suggests that fortified foods may be one way to ensure that these nutrient requirements are met, which could lower chronic health problems.

What is an example of a fortified food and are there positive health benefits to eating fortified food? Breakfast cereals are one of the most common fortified foods, and have been shown to augment intake of various micronutrients such as vitamin D, vitamin A, vitamin C, and calcium, which are micronutrients lacking in Americans’ diet. There is a large body of scientific research that demonstrates the positive relationship between nutrient intake and breakfast cereal consumption. Moreover, studies in children and adolescents have shown the consumption of ready to eat cereals is associated with increased nutrient intakes and lower body mass index (BMI).                                   

As such, nutrients that are supplied through fortification of food may assist many Americans to meet the daily requirements of many vital micronutrients. Processed foods that have been fortified with healthful components can provide additional avenues for Americans to meet nutrient requirements and improve health. The contribution of the fortification of food has enhanced the overall nutritional status of millions of Americans.